Which of the following is a clinical sign of pulmonary edema?

• A. Diffuse bilateral crackles
• B. Swelling in extremities
• C. Pink frothy sputum
• D. Increased JVD

Answer: (A)

Pulmonary edema causes fluid to accumulate in the interstitial and alveolar spaces, which disrupts normal air movement and produces crackling sounds as air moves through fluid-filled tissue. These crackles, especially when heard diffusely across the lungs or at the bases early and then more generally as edema progresses, are a classic clinical sign of pulmonary edema.

Other signs like swelling in the extremities, pink frothy sputum, or elevated neck veins can occur with heart failure and volume overload, but they’re not as specific to fluid in the lungs. Diffuse bilateral crackles directly reflect fluid in the pulmonary parenchyma, making them the best indicator among the options.