A 78-year-old man is recovering after an ST elevation myocardial infarction (STEMI). In the past hour, his pulse rate has increased from 100 to 130 bpm and his respiratory rate from 20 to 30 breath/min. The junior doctor is called. The patient has a productive cough and is sitting forward with his hands on his knees. Which single treatment is most likely to reverse this man's deterioration?
سؤال مجاني 1 من 10 اليوم · اشترك وكمّل بدون حد
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الإجابة والشرح
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الإجابة: C. Furosemide 80mg IV
After a STEMI, sudden tachycardia, tachypnoea, productive cough and sitting forward to breathe point to acute LV failure with pulmonary oedema (a known early complication of MI). Acute decompensated HF is treated with IV furosemide (40–80 mg), which acts fast. Oral thiazide or oral bumetanide is too slow/weak for an emergency, and metoprolol is avoided in acute heart failure (beta-blockers are given only if there is no hypotension or heart failure).
ليش كل خيار صح أو غلط
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A
ليش غلط
Thiazide-like diuretics are only used to augment diuresis alongside a loop diuretic, not as the main emergency treatment.
✓ Step-Up To Medicine 6th (HF).pdf · p. 8 -
B
ليش غلط
Bumetanide is a loop diuretic, but the oral loop diuretic is listed for chronic symptom relief; acute decompensated HF uses IV furosemide.
✓ view-material.pdf · p. 98 -
C
ليش صح
Acute LV failure after STEMI (pulmonary oedema) is treated with IV furosemide 40–80 mg, with the patient sat upright.
✓ view-material.pdf · p. 98 -
D
ليش غلط
A beta-blocker such as metoprolol is given post-MI only if no hypotension or heart failure; he has acute failure.
✓ Step-Up To Medicine 6th (IHD & ACS).pdf · p. 14
- المصدر
- view-material.pdf · p. 98
Step-Up To Medicine 6th (IHD & ACS).pdf · p. 14
4• Coronary Artery Disease [Notes].pdf · p. 4 - المحاضرة
- Acute Coronary Syndrome · Cardiology · Module B
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