Cardiology--chf
Review questions based on Medina's lecture and the book without any objectives provided by Keuter.
- 1.
Congestive heart failure is:
- A.
Common in younger to middle aged patients
- B.
Caused by structural and not functional cardiac disorder impairing ventricular filling
- C.
Inability of the heart to pump and supply the body's needs
- D.
The same as arrythmias, ischemia and obesity
Correct Answer
C. Inability of the heart to pump and supply the body's needs -
- 2.
Which of the following account for almost all of the casues of CHF? (multiple correct answers)
- A.
Obesity
- B.
Inappropriate workload placed on the heart
- C.
Poor diet
- D.
Restricted filling of the heart
- E.
Myocyte loss
- F.
Increased myocyte contractility
- G.
Decreased myocyte contractility
- H.
Bradycardia
Correct Answer(s)
B. Inappropriate workload placed on the heart
D. Restricted filling of the heart
E. Myocyte loss
G. Decreased myocyte contractilityExplanation
p. 258 McPhee/Hammer Pathophysiology bookRate this question:
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- 3.
Neurohormonal responses to impaired cardiac performance include:
- A.
Salt and water retention
- B.
Vasoconstriction
- C.
Sympathetic stimulation
- D.
All of the above
Correct Answer
D. All of the above -
- 4.
The short term effects of vasoconstriction augment preload on the heart and produce the long term effect of pulmonary congestion or anasarca.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
Salt and water retention lead to these resultsRate this question:
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- 5.
Of the responses listed below, which leads to the long term effect of increasing energy expediture?
- A.
Salt and water retention
- B.
Vasoconstriction
- C.
Sympathetic stimulation
- D.
None of the above
Correct Answer
C. Sympathetic stimulation -
- 6.
Hemodynamic abnormalities like LV dysfunction and change in heart shape produce the symptoms of CHF.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
Neurohormonal changes (activation of RASS and SNS) produce the progression of the disease.Rate this question:
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- 7.
This type of ventricular dysfunction leads to impaired contractility/ejection.
- A.
Systolic
- B.
Diastolic
- C.
Both systolic and diastolic
- D.
Neither systolic or diastolic
Correct Answer
A. SystolicExplanation
Diastolic is impaired filling/relaxationRate this question:
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- 8.
A normal ejection fraction is between 80-90%
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
50-70%Rate this question:
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- 9.
Mark each of the following that is true of systolic dysfunction
- A.
EF is normal or higher than normal
- B.
EF is diminished
- C.
LV is dilated
- D.
LV contractility reduced
- E.
Cavity size is small or "filled"
- F.
LV is hypertrophied
Correct Answer(s)
B. EF is diminished
C. LV is dilated
D. LV contractility reducedExplanation
Others are characteristic of diastolic dysfunctionRate this question:
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- 10.
Which of the following would you expect to see in left sided heart failure?
- A.
Dependent edema
- B.
Cough
- C.
Orthopnea
- D.
Ascities
- E.
Blood tinged sputum
- F.
Cyanosis
- G.
Paroxysmal nocturnal dyspnea
- H.
S3 on auscultation
Correct Answer(s)
B. Cough
C. Orthopnea
E. Blood tinged sputum
F. Cyanosis
G. Paroxysmal nocturnal dyspnea
H. S3 on auscultationExplanation
dependent edema and ascities are right sided failure onlyRate this question:
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- 11.
A patient presents with right sided heart failure. Which symptom below does NOT represent this diagnosis?
- A.
Cyanosis
- B.
Distended jugular veins
- C.
Orthopnea
- D.
Anorexia and GI distress
Correct Answer
C. Orthopnea -
- 12.
The gold-standard test for clinically treating CHF is:
- A.
Echocardiogram
- B.
Electrocardiogram
- C.
Chest X-ray
- D.
Cardiac catheterization
Correct Answer
A. Echocardiogram -
- 13.
Mark each labratory test necessary in an HF patient.
- A.
BNP
- B.
Fasting blood sugar
- C.
Ferritin levels
- D.
CK-MB and Troponin
- E.
Liver function tests
- F.
BUN/Creatinine
- G.
Thyroid panel
Correct Answer(s)
A. BNP
B. Fasting blood sugar
C. Ferritin levels
D. CK-MB and Troponin
E. Liver function tests
F. BUN/Creatinine
G. Thyroid panelExplanation
See page 4 medina's lecture
BNP--up due to ventricular stretch
BUN--could be up due to poor renal profusion from low cardiac output
CK-MB and troponin--could be eleveated due to dilated ventricleRate this question:
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- 14.
A BNP above which level is indicative and specific to HF?
- A.
100
- B.
200
- C.
400
- D.
1000
Correct Answer
D. 1000 -
- 15.
The degree of CHF severity can be correlated to the BNP level. The higher the BNP, the worse the problem.
- A.
True
- B.
False
Correct Answer
A. True -
- 16.
In-hospital mortality risk is higher if...
- A.
BUN>43, increased SrCr, increased BP
- B.
BUN>43, decreased SrCr, decreased BP
- C.
BUN>43, increased SrCr, decreased BP
- D.
BUN
Correct Answer
C. BUN>43, increased SrCr, decreased BP -
- 17.
What is the "formula" for determining whether or not there is LVH on an EKG?
- A.
V1 S wave + V5 R wave greater than or equal to 35mm
- B.
V5 S wave + V1 S wave greater than or equal to 35mm
- C.
Can't be determined on an EKG, you need an Echocardiogram
Correct Answer
A. V1 S wave + V5 R wave greater than or equal to 35mm -
- 18.
Which of the following are used to help control rate in atrial fibrillation. (Multiple correct choices)
- A.
Warfarin
- B.
CCBs
- C.
B-blockers
- D.
Nitrates
- E.
Digitalis
- F.
Amioderone
- G.
Hydralazine
- H.
Ablation and pacing
Correct Answer(s)
B. CCBs
C. B-blockers
E. Digitalis
F. Amioderone
H. Ablation and pacingExplanation
AF: Treatment Options (p. 6)Rate this question:
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- 19.
I have reviewed the risk factors for thromboembolism in AF and understand the recommended therapy. (In other words I don't know how to write a question for this.) :) (p.6)
- A.
True
- B.
False
Correct Answer
A. True -
- 20.
Diagnostic workup for A-fib does NOT include...
- A.
MRI
- B.
Echo
- C.
EKG
- D.
TEE
Correct Answer
A. MRI -
- 21.
AFFIRM demonstrated that rate control is an acceptable primary therapy in a selected high-risk subgroup of AF patients.
- A.
True
- B.
False
Correct Answer
A. True -
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Mar 07, 2013Quiz Edited by
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