A 48-year-old woman smoker with HTN and T2DM has chronic dry cough; on lisinopril for 3 months and metformin. BNP 20, spirometry normal. What is your next action?
سؤال مجاني 1 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: C. Stop lisinopril and start another antihypertensive
A dry cough starting after lisinopril, with a normal BNP (no heart failure) and normal spirometry (no asthma/COPD), is the classic ACE-inhibitor cough (bradykinin build-up). Stop the ACE inhibitor and switch to another antihypertensive, e.g., an ARB, which does not cause cough. Salbutamol, CXR and echo do not address the cause.
ليش كل خيار صح أو غلط
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C
ليش صح
Stop the ACE inhibitor and switch to an ARB: ARBs do not affect bradykinin metabolism, so they are not associated with the dry cough of ACE inhibitors.
✓ (Y4)-(M B) Therapeutic HTN Slides.pdf · p. 17 -
D
ليش غلط
Echo is for suspected heart failure, but her BNP is 20: a negative BNP reduces the chance of HF, and BNP above 100 pg/mL is what correlates with decompensated CHF.
✓ (Y4)-(M B) HF.pdf · p. 4
- المصدر
- CARDIOLOGY-HTN.pdf · p. 9
(Y4)-(M B) Therapeutic HTN Slides.pdf · p. 17 - المحاضرة
- Asthma · Pulmonology · Module B
- ظهر في
- MED41 ♀ EOM B