GIM Question 1

A 65-year old man is admitted to your ward with worsening dyspnea over the last two days. He has noticed increased swelling of his legs, and has had episodes of waking up short of breath for the past two nights. He has a history of congestive heart failure, and is taking furosemide 40mg PO daily at home. Physical exam demonstrates normal heart sounds, crackles at the base of both lungs, and pitting edema at both ankles up to his knees.

  1. What clinical syndrome is this patient demonstrating?
  2. What initial steps would you take in the management of this condition?
  3. What change, if any, would you make to the patient’s home medication?

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