RAAS Inhibitor Renal Effects — EECC MCQ
Instant feedback + full explanation. One question, done properly.
Educational content. Not a substitute for clinical judgement or local policy.
Reveal the answer and explanation
Correct answer: A — Remove reversible causes, adjust ramipril and repeat bloods
The creatinine rise is about 32%, exceeding the commonly accepted 30% trigger for reassessment, and potassium is also elevated. NSAID use is a reversible contributor. The appropriate response is prompt medication and volume review, removal of nephrotoxins, dose adjustment or temporary withholding as clinically indicated, and repeat testing—not automatic permanent loss of prognostic therapy or unmonitored continuation. Apply this conclusion only to the clinical circumstances stated, with appropriate specialist review, contraindication checks, shared decision-making and follow-up. Reassess if the physiology, treatment response or competing risk changes. The competing options would require a different haemodynamic profile, diagnosis, procedural indication or risk balance from the one described here.
Reference: NICE NG106: chronic heart failure in adults. https://www.nice.org.uk/guidance/ng106/chapter/recommendations