A 83-year-old man with a CFS of 5, heart failure, and chronic pain has been on Naproxen 500 mg BD for 3 months for osteoarthritis. He is also on Ramip...

Question

A 83-year-old man with a CFS of 5, heart failure, and chronic pain has been on Naproxen 500 mg BD for 3 months for osteoarthritis. He is also on Ramipril 10 mg and Furosemide 40 mg. Over the past 2 weeks, his ankles have swollen, he has gained 4 kg, and his breathlessness has worsened. His eGFR has declined from 52 to 34. What is the MOST likely cause of his deterioration?

Accepted Answer

NSAID-induced fluid retention, renal impairment, and heart failure exacerbation

Answer

Progression of heart failure due to natural disease course

Answer

Excessive salt intake

Answer

Ramipril causing fluid retention

Answer

Furosemide resistance

uk-dgm MCQ (SBA): Triple Whammy - NSAID, ACEi, Diuretic Interaction