Internat Médecine (Côte D'Ivoire) Practice Questions - Concours National D'Internat Des Hôpitaux En Médecine (Côte D'Ivoire) Exam

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A 62-year-old hypertensive patient presents to the emergency department with acute respiratory distress, orthopnea, bilateral basal crackles extending to mid-lung fields, jugular venous distension, blood pressure 195/110 mmHg, and oxygen saturation 84% on ambient air. What is the most appropriate initial pharmacological combination?

High-flow oxygen, intravenous furosemide bolus (40–80 mg), and sublingual/intravenous isosorbide dinitrate or nitroglycerin infusion Intravenous digoxin 0.5 mg bolus and oral spironolactone 50 mg Intravenous beta-blocker (labetalol) bolus and aggressive volume loading with normal saline Subcutaneous low-molecular-weight heparin and oral amlodipine 10 mg

Correct Answer:

High-flow oxygen, intravenous furosemide bolus (40–80 mg), and sublingual/intravenous isosorbide dinitrate or nitroglycerin infusion

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