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Severe hyperkalaemia — RCPSC IM MCQ

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HardNephrologySevere hyperkalaemiaRCPSC IM

A patient with diffuse systemic sclerosis has progressive dyspnea, falling DLCO and HRCT-confirmed fibrotic NSIP. Echocardiography does not suggest pulmonary hypertension. Which next management principle is most appropriate?

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Correct answer: E — Refer for ILD therapy and serial lung-function assessment

SSc-associated ILD with physiologic progression requires specialist ILD treatment planning and serial objective assessment. High-dose glucocorticoids can increase renal-crisis risk and ACE inhibition, antibiotics or delayed observation do not treat progressive fibrosis.

Reference: Canadian Rheumatology Association, Clinical Guidelines and Position Statements: https://rheum.ca/resources/publications/