Question

Arrange the given steps in the pathogenesis of cardiac oedema due to congestive heart failure (CHF) in order of occurrence:
(A) It leads to renal retention of sodium and water.
(B) It leads to hypovolemia.
(C) CHF leads to reduced cardiac output.
(D) Extra-renal (aldosterone) mechanism, intrinsic-renal mechanism ADH secretion are stimulated.

• A. (A), (B), (C), (D)
• B. (A), (B), (C), (D)
• C. (A), (C), (B), (D)
• D. (C), (B), (A), (D)
• E.

Hint:

In CHF, the kidneys’ response to fluid retention worsens the condition by increasing fluid overload.

Answer 1

The Correct Option is A

Step 1: Understanding Pathogenesis.
Congestive heart failure (CHF) occurs when the heart inadequately pumps blood, resulting in fluid accumulation and swelling (oedema).
Step 2: Breakdown of Steps.
- (A) Renal retention of sodium and water: Declining cardiac function triggers kidney retention of sodium and water, increasing fluid volume.
- (B) Hypovolemia development: Increased fluid retention leads to hypovolemia (reduced circulating blood volume) as the body attempts to compensate for low cardiac output.
- (C) Reduced cardiac output in CHF: The heart's diminished pumping capacity lowers blood supply to organs, worsening symptoms.
- (D) Stimulation of Extra-renal and Intrinsic-renal Mechanisms: The body activates aldosterone and antidiuretic hormone (ADH) secretion to retain water and sodium, counteracting hypovolemia.
Step 3: Conclusion.
The correct sequence of events is (A), (B), (C), and (D).