Heart Failure Nemecek

Question 1

What is the hallmark symptom of HF?

Answer 1

Orthopnea

Question 2

What are the 5 physical symptoms of HF?

Answer 2

1. Dyspnea
2. Orthpnea
3. Cough
4. Fatigue
5. Nausea and poor appetite

Question 3

What are 5 signs of HF?

Answer 3

1. Pulmonary edema
2. Cool extremities
3. Cardiomegaly
4. Peripheral edema
5. Venous status changes

Question 4

What is synthesized and released from the ventricle due to stress or volume overload?

Answer 4

BNP

Question 5

What level of BNP is considered elevated?

Answer 5

> 100 pg/mL

Question 6

What would you give for a high BNP?

Answer 6

Diuretics

Question 7

Why would serum creatinine be increased in HF?

Answer 7

Due to hypoperfusion

Question 8

What indicates volume overload and is associated with worse outcomes?

Answer 8

Hyponatremia

Question 9

HFrEF has an ejection fraction of ____

Answer 9

< 40%

Question 10

HFpEF has an ejection fraction of ____

Answer 10

> 60%

Question 11

What class?: patient has no limitations. Ordinary activity does not cause dyspnea, fatigue or palpitations

Answer 11

Class 1

Question 12

What class? : patient has a slight limitation when doing physical activity, but is comfortable at rest. Ordinary physical activity results in fatigue, palpitations, or dyspnea

Answer 12

Class 2

Question 13

What class? : patient is comfortable at rest, but when doing less than ordinary activity experiences fatigue, palpitations or dyspnea

Answer 13

Class 3

Question 14

What class? : patient is unable to carry out any physical activity without discomfort and has symptoms of HF when at rest

Answer 14

Class 4

Question 15

Who gets ACE/ARB?

Answer 15

Anyone with a decreased EF

Question 16

What medication has a benefit in African American patients only?

Answer 16

Hydralazine/ Isosorbide dinitrate

Question 17

What 3 drugs have a mortality benefit in HF?

Answer 17

1. Metoprolol succinate
2. ACE I/ARBS
3. Spironolactone if EF <35%

Question 18

What 4 drugs can cause hyperkalemia?

Answer 18

1. ACE i
2. Spironolactone/eplerenone
3. ARBs
4. Entresto

Question 19

What do clinicians need to know before starting entresto?

Answer 19

36 hr washout pd with ACE i

Question 20

True or false: everyone who has HF should receive an SGLT2

Answer 20

True

Question 21

What drug is a replacement for beta-blockers?

Answer 21

Ivabradine

Question 22

What do you give if a Pt has dyspnea or othopnea?

Answer 22

Diuretic

Question 23

What drug class can you give to increase cardiac output?

Answer 23

Beta blockers

Question 24

When would you start a pt on a beta blocker?

Answer 24

EF < 40%