CHF

Question 1

Complex clinical syndrome that results from either structural or functional impairment of ventricular filling or ejection of blood

Answer 1

Congestive heart failure

Question 2

Cardinal clinical symptoms

Answer 2

Dysnea

fatigue

Question 3

Signs of heart failure

Answer 3

Edema

Rales

Question 4

EF <40%

Systolic failure

Answer 4

Heart failure with reduced ejection fraction

Question 5

HF >50%

Diastolic failure

Answer 5

Heart failure with preserved ejection fraction

Question 6

Depressed ejection fraction >40-50%

Answer 6

CAD- MI
Chronic pressure overload-HPN
Chronic volume overload
Chronic lung disease
Chagas disease

Question 7

Preserved Ejection <40%

Answer 7

Hypertrophic cardiomyopathies
HPN
Aging
Restrictive cardiomyopathy- sarcoidosis, amyloidosis
Hemochromatosis
Fibrosis

Question 8

High output states

Answer 8

Thyrotoxicosis
Beriberi
Systemic arteriovenous shunting
Chronic anemia

Question 9

Decreased ventricular contraction, CAD, dilated cardiomyopathy, Low EF

Answer 9

Systolic dysfunction

Question 10

Noncompliant ventricle, Concentric LVH

Answer 10

Diastolic dysfunction

Question 11

Most common cause of myocarditis?

Answer 11

Coxsackie B virus

Question 12

Post MI pericarditis

Answer 12

Dressler’s syndrome

Question 13

Most common cause of restrictive cardiomyopathy?

Answer 13

Amyloidosis

Question 14

2D Echo finding of amyloidosis

Answer 14

Sparkling granular appearance

Question 15

No limitation of physical activity

Ordinary activity does not cause fatigue

Answer 15

NYHA CLASS I

Question 16

Slight limitation of physical activity

Ordinary activity results in fatigue

Answer 16

NYHA CLASS II

Question 17

Marked limitation

Less than ordinary activity causes fatigue

Answer 17

NYHA CLASS III

Question 18

Inability to carry out physical activity

Symptomatic at rest

Answer 18

NYHA CLASS IV

Question 19

HF with Preserved Ejection Fraction

Answer 19

Control congestion
Improve exercise tolerance
Stabilize HR and BP
- CANDESARTAN (CHARM trial)
-DIGOXIN and NEBIVOLOL trial: ineffective

Question 20

Cornerstone therapy for HFREF

Answer 20

RAAS blockers

Beta blockers

Question 21

Beneficial to HF are limited to these 3 Beta-blockers

Answer 21

Carvedilol
Bisoprolol
Metoprolol succinate

Question 22

For HFREF, initial strategy

Answer 22

ACEI + BB

Question 23

If ACEI intolerant

Answer 23

ARB + BB

Question 24

If symptomatic NYHA II-IV?

Answer 24

ARB + BB + ALDOSTERONE ANTAGONIST ( SPIRONOLACTONE AND EPLERENONE)

Question 25

4 drug therapy should be avoided

Answer 25

True

Question 26

For HFREF

Answer 26

``` Hydralazine + Nitrates Ivabradine Valsartan + sacubitril Diuretics Aspirin ```

Question 27

Control heart rate, acts on funny channels

Answer 27

Ivabradine (Coralan)

Question 28

Hyperpolarization activated cyclic nucleotide gated channel blockers Lower heart rate without affecting contractility

Answer 28

Ivabradine

Question 29

Endopeptidase inhibitor

Answer 29

Sacubitril

Question 30

Angiotensin receptor neprilysin inhibitor (ARNI)

Answer 30

Sacubitril