Diuretic Resistance HF — RACP Adult Medicine MCQ

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ModerateCardiologyDiuretic Resistance HFRACP Adult Medicine

A 72-year-old man with CHF and AF on furosemide 80 mg BD has diuretic-resistant fluid overload. What advanced decongestive strategy?

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Correct answer: B — IV furosemide infusion plus metolazone (sequential nephron blockade)

Sequential nephron blockade (loop + thiazide) dramatically enhances diuresis. Requires close electrolyte monitoring.

Reference: NHF/CSANZ – 2022; eTG – 2025 – Cardiovascular