Question

Sequence of events for development of pulmonary congestion and oedema:
A. Na\(^+\) and water retention
B. Activation of renin-angiotensin-aldosterone system
C. Decreased cardiac output because of valvular heart disease
D. Tissue anoxia
E. Decreased renal perfusion
Choose the correct answer from the options given below:

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

Hint:

Low CO → Low renal perfusion → RAAS → Fluid retention → Edema

Answer 1

The Correct Option is A

Concept:
Pulmonary congestion and edema are often consequences of heart failure, especially due to reduced cardiac output leading to compensatory mechanisms such as RAAS activation.

Step 1: Initial cause – decreased cardiac output.
Due to valvular heart disease:
• Cardiac output decreases Thus: \[ C: Decreased cardiac output \]

Step 2: Development of tissue hypoxia.

• Reduced blood supply causes tissue anoxia Thus: \[ D: Tissue anoxia \]

Step 3: Reduced renal perfusion.

• Kidneys receive less blood flow Thus: \[ E: Decreased renal perfusion \]

Step 4: Activation of compensatory mechanism.

• RAAS system is activated due to low perfusion Thus: \[ B: Activation of RAAS \]

Step 5: Fluid retention.

• Sodium and water retention occurs
• Leads to edema and congestion Thus: \[ A: Na\(^+\) and water retention \]

Step 6: Final sequence.
\[ C \rightarrow D \rightarrow E \rightarrow B \rightarrow A \] \[ \boxed{\text{Correct answer = Option (1)}} \]