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Acute pulmonary oedema — DIPIMC MCQ

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ModerateMedical EmergenciesAcute pulmonary oedemaDIPIMCDipIMC

A patient is acutely breathless with frothy pink sputum and widespread crackles. The blood pressure is 170/100, oxygen saturations are 86 percent and the patient is sitting forward.

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

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Correct answer: C — Sit the patient upright, give oxygen and give sublingual or intravenous glyceryl trinitrate.

Acute cardiogenic pulmonary oedema with hypertension is managed by sitting the patient upright, giving oxygen and giving nitrates to reduce preload and afterload, with consideration of continuous positive airway pressure. Lying the patient flat and giving fluids worsens pulmonary congestion. Salbutamol and adenosine do not address the underlying problem.

Reference: JRCALC Clinical Guidelines