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EasyCardiovascularAcute pulmonary oedemauk-plab-1

A 72-year-old woman with a history of hypertension and chronic kidney disease presents with sudden onset dyspnoea, pink frothy sputum and severe orthopnoea. On examination she has bilateral basal crackles, raised JVP and pitting ankle oedema. BP is 180/100 mmHg, SpO2 86% on air. What is the most appropriate immediate management?

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