Quiz

A 72-year-old woman with end-stage renal disease secondary to diabetic nephropathy, who had received a deceased donor kidney transplant 9 years ago, presented to the emergency department via ambulance with 5 days of shortness of breath, paroxysmal nocturnal dyspnea, and abdominal bloating. On examination, blood pressure was 152/70mm Hg, heart rate was 65 beats/min, oxygen saturation was 94% with 4L of oxygen by nasal prongs, jugular venous pulse was elevated, and peripheral edema was noted to midshins bilaterally.

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