HF 1

Question 1

what is used to classify HF

Answer 1

left ventricular ejection fraction

Question 2

HFpEF value

Answer 2

EF >50%

Question 3

HFrEF value

Answer 3

EF less than or equal to 40%

Question 4

NYHA I

Answer 4

No limitation on physical activity. Ordinary activity does not cause HF sx

Question 5

NYHA II

Answer 5

Some limitation on physical activity. Comfortable at rest, but ordinary physical activity results in HF sx

Question 6

NYHA III

Answer 6

Marked limitation on physical activity. Comfortable at rest, but less than ordinary activity causes HF sx.

Question 7

NYHA IV

Answer 7

Unable to carry on any physical activity w/o sx of HF, or HF sx at rest

Question 8

HF etiology list
10

Answer 8

1. myocardial damage
2. valvular disorders
3. some arrhythmias
4. conduction disorders
5. cardiomyopathies
6. infiltrative disorders
7. genetic conditions
8. increases cardiac output demands
9. increased afterload
10. excess fluid or sodium

Question 9

valvular disorders than can lead to HF
2

Answer 9

1. aortic stenosis
2. mitral regurgitation

Question 10

arrhythmias that can cause HF
3

Answer 10

1. a fib
2. brady arrhythmias
3. tachy arrhythmias

Question 11

disorders that increase afterload that can lead to HF
2

Answer 11

1. aortic stenosis
2. hypertension

Question 12

what is afterload

Answer 12

the amount of pressure that the heart needs to exert to eject blood during ventricular contraction

Question 13

HF common risk factors
11

Answer 13

1. HTN
2. CAD
3. MI
4. DM
5. metabolic syndrome, obesity
6. family history of CVD
7. 65 or older
8. alcohol abuse
9. pregnancy
10. sleep apnea
11. toxins (chemo, drugs, alcohol)

Question 14

The most common sx of HF are
2

Answer 14

dyspnea
fatigue

Question 15

mild HF sx include
10

Answer 15

1. crackles in lungs
2. S3 gallop
3. JVD
4. dyspnea on exertion
5. nocturia
6. tachycardia
7. diminished exercise capacity
8. fatigue/weakness
9. peripheral edema
10. weight gain

Question 16

moderate HF sx
7

Answer 16

1. cough, especially nocturnal
2. crackles in lung bases
3. PND - SOB that awaken pt, usually relieved by upright position
4. tachypnea/SOB
5. tachycardia
6. hepatomegaly/ascites
7. edema - peripheral, presacral, scrotal

Question 17

severe HF sx
5

Answer 17

1. ascites
2. cyanosis/poor perfusion
3. decreased LOC
4. frothy sputum or pink sputum
5. hypotension

Question 18

lab diagnostic study for HF
2

Answer 18

BNP or NT-proBNP - natriuretic peptide biomarkers

Question 19

Cardiac conditions that can cause an increased level of natriuretic peptide biomarkers
10

Answer 19

1. HF
2. ACS
3. heart muscle disease
4. valvular HD
5. pericardial disease
6. a fib
7. myocarditis
8. cardiac surgery
9. cardioversion
10. toxic metabolic myocardial insults - including cancer chemo

Question 20

Non-Cardiac conditions that can cause an increased level of natriuretic peptide biomarkers
8

Answer 20

1. advanced age
2. anemia
3. renal failure
4. pulmonary - OSA, PNA
5. pulmonary HTN
6. critical illness
7. bacterial sepsis
8. severe burns

Question 21

HF preferred study for initial w/u

Answer 21

transthoracic echocardiogram or 2-D doppler flow study

Question 22

transthoracic echocardiogram or 2-D doppler flow study assess what
2

Answer 22

1. est ejection fraction
2. valve function and structure

Question 23

HF EKG can assess for
3

Answer 23

1. arrhythmias
2. left ventricular hypertrophy
3. recent/previous MI as underlying cause

Question 24

HF - why check CBC
2

Answer 24

assess for anemia and infection

Question 25

HF - check what electrolytes
4

Answer 25

K
Ca
Na
Magnesium

Question 26

HF - why check UA

Answer 26

if proteinuria >1 g/24 hours or not reversed within 2 weeks of successful HF therapy, consider w/u for intrinsic renal disease

Question 27

late sx of HF

Answer 27

weight gain - occurs almost 3 weeks after decompensation has begun, occurs in about 50% of patients

Question 28

what vaccines are recommended for HF patients
2

Answer 28

flu
pneumococcal

Question 29

pharm - triple therapy is recommended in what classes

Answer 29

NYHA class II-III

Question 30

triple therapy for HF

Answer 30

1. ACE inhibitor
2. ARB or ARNI
3. BB or aldosterone receptor antagonist