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HFpEF congestion — USMLE Step 3 MCQ

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ModerateInternal Medicine (chronic management)HFpEF congestionUSMLE Step 3

A 76-year-old woman with heart failure with preserved ejection fraction has worsening ankle swelling and dyspnea after increased restaurant meals. Echocardiogram 6 months ago showed ejection fraction 60%. Blood pressure is 136/78 mm Hg, oxygen saturation is 96%, and creatinine is stable. Which of the following is the most appropriate next step in management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Adjust loop diuretic dose and counsel on sodium restriction

HFpEF management focuses on volume control, blood pressure and comorbidity management, and SGLT2 inhibitors in eligible patients; diuretics treat congestion.

Reference: ACC/AHA/HFSA Heart Failure Guideline