A 65-year-old male has a 5-day history of dyspnea and paroxysmal nocturnal dyspnea, and a 1 year ago history of ST elevation MI. His BP 180/110, HR 110 and regular. His lung examination reveals bibasilar crackles and wheeze. What most appropriate step to manage this patient?
سؤال مجاني 6 من 10 اليوم · اشترك وكمّل بدون حد
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الإجابة: B. IV furosemide
Orthopnoea/PND, bibasilar crackles and wheeze ('cardiac asthma') in a post-MI hypertensive patient = acute decompensated heart failure with pulmonary oedema. The most important intervention is an IV loop diuretic (furosemide) to remove volume and reduce preload (vasodilators help if hypertensive). Digoxin takes weeks to work and is not used acutely; beta-blockers worsen contractility in decompensated HF; anticoagulation does not treat the congestion.
ليش كل خيار صح أو غلط
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A
ليش غلط
Digoxin takes several weeks to work and is not indicated in an acute setting.
✓ Step-Up To Medicine 6th (HF).pdf · p. 11 -
B
ليش صح
In acute decompensated HF, diuretics for volume overload and congestive symptoms are the most important intervention; they decrease preload.
✓ Step-Up To Medicine 6th (HF).pdf · p. 11 -
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
Anticoagulation is not among the listed acute decompensated HF treatments (oxygenation/ventilation, diuretics, vasodilators, inotropes, salt and fluid restriction).
✓ Step-Up To Medicine 6th (HF).pdf · p. 11
- المصدر
- Step-Up To Medicine 6th (HF).pdf · p. 11
Cardiac emergencies.pdf · p. 1 - المحاضرة
- Acute Pulmonary Oedema · Cardiology · Module B
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- Cardio bank