A 54-year-old male with a past medical history of type 2 diabetes mellitus comes to the emergency department complaining of shortness of breath. His blood pressure is 146/92 mmHg, respiratory rate is 26 bpm, and oxygen saturation is 87% on room air. Cardiac auscultation revels third heart sound and chest auscultation reveals bilateral basal inspiratory fine crackles. Based on the physical findings Which of the following in the best initial therapy for this patient?
سؤال مجاني 2 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
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الإجابة: E. Intravenous diuretics
S3, bilateral basal fine crackles, hypoxia and tachypnoea with preserved BP = acute decompensated heart failure / pulmonary oedema. Besides sitting up and oxygen, IV loop diuretics to relieve volume overload are the key initial therapy (IV nitrate can be added if not hypotensive). IV beta blockers or diltiazem are negative inotropes and can worsen acute HF; bronchodilators treat bronchospasm, and pericardiocentesis is for tamponade.
ليش كل خيار صح أو غلط
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B
ليش غلط
Beck's triad of tamponade (hypotension, muffled heart sounds, distended neck veins) is absent: BP is 146/92 and he has an S3 with crackles.
✓ Cardiology 🫀.pdf · p. 44 -
C
ليش غلط
Beta-blockers are to be avoided in decompensated heart failure until the patient is stabilised.
✓ (Y4)-(M B) HF.pdf · p. 5 -
D
ليش غلط
Calcium channel blockers (except amlodipine) are among the drugs to avoid in heart failure.
✓ (Y4)-(M B) HF.pdf · p. 6 -
E
ليش صح
In acute pulmonary oedema, diuretics treat volume overload and congestion and are the most important intervention.
✓ Heart failure عبدالرحمن✅.pdf · p. 18
- المصدر
- Heart failure عبدالرحمن✅.pdf · p. 18
- المحاضرة
- Acute Pulmonary Oedema · Cardiology · Module B
- ظهر في
- Cardio bank