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A 46-Year-Old Man Comes to the Physician Due to Exertional

Question 2

Multiple Choice

A 46-year-old man comes to the physician due to exertional dyspnea and dry cough.  He also has occasional episodes of suffocating nighttime cough that is relieved only by sitting up.  Medical history is significant for myocardial infarction 6 months ago and hypercholesterolemia.  Current medications include metoprolol, aspirin, and rosuvastatin.  The patient drinks alcohol on social occasions but does not use tobacco or illicit drugs.  His father died of a stroke and his mother has type 2 diabetes mellitus.  Blood pressure is 150/100 mm Hg and pulse is 60/min.  Chest examination shows bibasilar crackles.  The cardiac apex is palpated in the left sixth intercostal space.  Bilateral pitting leg edema is present.  Which of the following is most likely to be associated with this patient's condition?


A) Constriction of the renal efferent arterioles
B) Decreased plasma colloid pressure
C) Decreased renal venous pressure
D) Dilation of the renal afferent arterioles
E) High sodium delivery to the distal tubule
F) Increased chloride delivery to the macula densa

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