Which of the following is a classic sign of acute pulmonary edema?

• A. Pink frothy sputum
• B. Dyspnea
• C. Jaundice
• D. Rales

Answer: (D)

Fluid in the lungs from acute pulmonary edema floods the alveoli, changing how air moves and what you hear with a stethoscope. The hallmark sign is crackling sounds, or rales, heard during auscultation as the patient breathes. These sounds come from fluid-filled alveoli and interstitial spaces, so they’re a strong, characteristic indicator of edema in the lungs.

Dyspnea is a common symptom of this condition but isn’t as specific a sign on exam. Pink frothy sputum can occur as fluid mixes with air and mucus, but it isn’t always present. Jaundice has no direct connection to pulmonary edema. So the most classic, reliable sign you’d expect to find on a physical exam is rales.