HF – frusemide — RACP Paediatrics MCQ

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EasyCardiologyHF – frusemideRACP Paediatrics

A 4-month-old with a large VSD presents with heart failure (tachypnoea, hepatomegaly, failure to thrive). What is the most appropriate first-line diuretic?

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Correct answer: B — Frusemide

Frusemide (loop diuretic) is the first-line diuretic for acute and chronic heart failure in children. It reduces preload by promoting sodium and water excretion. Monitoring of electrolytes (hypokalaemia, hyponatraemia) and renal function is essential. Spironolactone is often added as a potassium-sparing adjunct.

Reference: RCH Melbourne – 2023 – Heart Failure CPG; RACP Paediatric Curriculum – Cardiology