Pharma Co-therapy Of Heart Failure Quiz
Understanding the pharmacotherapy of heart failure requires understanding most of the drugs and fundamentals of cardiology so far in this course. Ideally, you should be able to tie together the pathophysiology and recommend appropriate pharmacotherapy to treat the patient.
- 1.Which of the following may describe the pathophysiology of heart failure? Check all that may apply.
- A.
Structural impairment of heart
- B.
Functional impairment of heart
- C.
Decreased ventricular filling of blood
- D.
Decreased ventricular ejection of blood
- 2.Which of the following may cause heart failure? Check all that apply.
- A.
Myocardial infarction
- B.
Untreated hypertension
- C.
Stroke
- D.
Diabetes
- 3.Which of the following appropriately describes SYSTOLIC dysfunction? Check all that apply.
- A.
The contractility of the left ventricle is reduced
- B.
The rate of filling of the ventricles during diastole is slowed
- C.
The ventricle is dilated
- D.
The preload (end diastolic volume) is increased
- E.
The preload is not increased
- F.
The ejection fraction is decreased
- G.
The ejection fraction is not decreased
- 4.Which of the following appropriately describes DIASTOLIC dysfunction? Check all that apply.
- A.
The contractility of the left ventricle is reduced
- B.
The rate of filling of the ventricles during diastole is slowed
- C.
The ventricle is dilated
- D.
The preload (end diastolic volume) is increased
- E.
The preload is not increased
- F.
The ejection fraction is decreased
- G.
The ejection fraction is not decreased
- 5.True or False: Medications that show a benefit in studies in reducing all-cause mortality in HFrEF do not have the same benefit in HFpEF.
- A.
True
- B.
False
- 6.Atrial fibrillation would have a more deleterious effect on which type of heart failure?
- A.
Systolic dysfunction
- B.
Diastolic dysfunction
- 7.To which of the following areas is blood flow MOST reduced in heart failure?
- A.
Brain
- B.
Heart
- C.
Kidneys
- D.
Lungs
- 8.Which beta-blockers have been proven to have a morbidity and mortality benefit in heart failure? Check all that apply.
- A.
Metoprolol succinate
- B.
Metoprolol tartrate
- C.
Carvedilol
- D.
Propranolol
- E.
Bisoprolol fumarate
- 9.What are potential serious adverse effects of beta-blockers? Check all that apply.
- A.
Rebound hypertension, if not tapered
- B.
Decreased cardiac output
- C.
Hepatotoxicity at therapeutic doses
- D.
Hypermagnesemia
- 10.True or False: Diuretics have a mortality benefit in heart failure observed in studies.
- A.
True
- B.
False
- 11.Which ARBs have a mortality benefit proven by clinical trials? Check all that apply.
- A.
Candesartan
- B.
Losartan
- C.
Irbesartan
- D.
Valsartan
- 12.For a patient with acute renal insufficiency, which drug(s) would you want to avoid? Check all that apply.
- A.
Hydralazine
- B.
Isosorbide dinitrate
- C.
Lisinopril
- D.
Losartan
- 13.What is the target serum concentration of digoxin in heart failure?
- A.
0.1-0.5 ng/mL
- B.
0.3-0.7 ng/mL
- C.
0.5-0.9 ng/mL
- D.
0.7-1.1 ng/mL
- 14.Digoxin has benefits in which of the following?
- A.
Decreasing hospitalizations
- B.
Decreasing mortality
- C.
Reducing symptoms of heart failure
- D.
Treating atrial fibrillation
- 15.Which medication(s) should be avoided in heart failure patients? Check all that apply.
- A.
Acetaminophen
- B.
Diltiazem
- C.
Ibuprofen
- D.
Pioglitazone
- E.
Terazosin
- 16.Hypokalemia would have what effect on digoxin?
- A.
Decreased effect of digoxin
- B.
Effect that is not clinically significant
- C.
Increased effect of digoxin
- D.
No effect on digoxin
- 17.What is the primary reason for using dobutamine or dopamine in a heart failure patient?
- A.
Acute improvement in sodium levels to treat hyponatremia
- B.
Acute treatment of hypertension
- C.
Short-term support in acute decompensated heart failure
- 18.BS is an acutely decompensated heart failure patient with a cardiac index of 2.0 L/min/2. Is BS at goal with regard to her cardiac index?
- A.
Yes
- B.
No
- 19.BS is an acutely decompensated heart failure patient. Her pulmonary capillary wedge pressure is 22 mmHg. Is BS at goal with regard to her pulmonary capillary wedge pressure?
- A.
Yes
- B.
No
- 20.A patient with a cardiac index of 2.0 L/min/m2 and a PCWP of 22 mmHg would be classified by the Forrester Hemodynamic Classification as which subset?
- A.
Subset 1: warm and dry
- B.
Subset 2: warm and wet
- C.
Subset 3: cold and dry
- D.
Subset 4: cold and wet
- 21.True or False: Beta-blockers should be discontinued for an acutely decompensated patient with a Forrester Hemodynamic Classification of stage II.
- A.
True
- B.
False
- 22.For an acutely decompensated patient with an elevated PCWP, loop diuretics should be given at what dose relative to the patient's home dose?
- A.
Doubled home dose PO
- B.
Doubled home dose IV
- C.
Same home dose PO
- D.
Same home dose IV
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