Author: Davinder Tegally, Muhammad Hamza / Editor: Nick Tilbury / Codes: CC9, SLO1, SLO3 / Published: 09/06/2025
A 37-year-old asthmatic woman presents to the emergency department (ED) with a 12-hour history of shortness of breath present at rest and worse on exertion. She reports recent dizziness and a dry cough and has been experiencing migraines for about 1 year, which she feels is due to work stress.
Despite giving standard asthma treatment in ED, her symptoms persist.
On examination, she is severely hypertensive at 243/107 and tachypnoeic. On auscultation you can hear two heart sounds and no murmur. There are widespread inspiratory crepitations on auscultation and she has moderate pitting oedema to both lower legs. Though she has no focal neurological signs, she does appear to be slightly confused.
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Question 1 of 3
1. Question
What is the most appropriate immediate management in this patient?
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Question 2 of 3
2. Question
A chest x-ray is obtained, what is the abnormality detected in this patient?
Fig. 1 - image courtesy of the author
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Question 3 of 3
3. Question
What is the most appropriate goal when treating this patient's blood pressure? (Select all that apply)
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3 responses
Excellent case discussion.
Very nice module.
Nice one thanks