Arab Board Internal Medicine Clinical Exam Practice Questions - Arab Board Internal Medicine Final Clinical And Oral Examination (ABHS) Exam

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A 68-year-old man with ischemic cardiomyopathy presents with severe acute dyspnea, orthopnea, and pink frothy sputum. Blood pressure is 185/105 mmHg, heart rate is 118 bpm, and oxygen saturation is 84% on ambient air. Bilateral diffuse coarse crackles and wheezes are present throughout all lung zones. What is the most appropriate initial combination therapy?

Intravenous beta-blocker, high-flow nasal cannula, and oral spironolactone Non-invasive positive pressure ventilation (CPAP/BiPAP), intravenous loop diuretic, and intravenous vasodilator (nitroglycerin) Immediate endotracheal intubation, intravenous diltiazem, and rapid 0.9% saline infusion Intravenous digoxin, subcutaneous heparin, and oral sacubitril-valsartan

Correct Answer:

Non-invasive positive pressure ventilation (CPAP/BiPAP), intravenous loop diuretic, and intravenous vasodilator (nitroglycerin)

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