HF practice questions

Question 1

Halos in vision may be the sign of what toxicity?
a) Warfarin
b) Heparin
c) Digoxin
d) Amiodarone

Answer 1

c) Digoxin

Question 2

Which of the following does NOT have negative inotropic effects on the heart?
a) Amlodipine
b) Amiodarone
c) Propanolol
d) Verapamil

Answer 2

a) Amlodipine

Question 3

What are the initial daily doses for CCBs in HF?
a) Verapamil 110 mg, diltiazem 80 mg, and amlodipine 3.5 mg
b) Verapamil 120 mg, diltiazem 90 mg, and amlodipine 2.5 mg
c) Verapamil 90 mg, diltiazem 120 mg, and amlodipine 2.5 mg
d) Verapamil 2.5 mg, diltiazem 110 mg, and amlodipine 80 mg

Answer 3

b) Verapamil 120 mg, diltiazem 90 mg, and amlodipine 2.5 mg

Question 4

Your patient has DM and HF. What are the first 2 drugs you’ll start them on?
a) Dapagliflozin (Farxiga) and Empagliflozin (Jardiance)
b) Pioglitazone + Empagliflozin (Jardiance)
c) Amiodarone + Pioglitazone
d) Dapagliflozin (Farxiga)

Answer 4

c) Amiodarone + Pioglitazone

Question 5

What is a sensitive short-term marker of fluid loss or retention in HF? Choose the best answer
a) Reporting weight changes >5lbs
b) Reporting weight changes greater than 3-5lbs
c) Reporting weight changes 3-5lbs
d) Reporting weight changes greater than 1lb but less than 3-5lbs

Answer 5

c) Reporting weight changes 3-5lbs

Question 6

What is one of the first signs of hyperkalemia a patient might notice?
a) Vomiting
b) Dizziness
c) Diarrhea
d) Halo in vision

Answer 6

c) Diarrhea

Question 7

Your patient has HF. What is the target serum concentration of digoxin?
a) 0.9 – 2.0 ng/mL
b) 0.8 – 2.0 ng/mL
c) 0.5 – 0.9 ng/mL
d) 0.5 – 0.8 ng/mL

Answer 7

c) 0.5 – 0.9 ng/mL

Question 8

A patient with acute decompensated HF has a cardiac index of 2.0 and a pulmonary capillary wedge pressure of 20. What category are they and what do you need to assess next?

Answer 8

Subset 4 (cold and wet); assess SBP and/or PAC

Question 9

A patient with acute decompensated HF has a cardiac index of 1.0 and a pulmonary capillary wedge pressure of 17. What category are they and what do you need to assess next?

Answer 9

Subset 3 (cold and dry); assess volume status and/or PAC.

Question 10

A patient with acute decompensated HF has a cardiac index of 2.0 and a pulmonary capillary wedge pressure of 20. Their SBP is 95mmHg. You give them an IV diuretic and IV vasodilator, but they don’t improve. What do you do?

Answer 10

IV inotrope and/or vasopressor + IV diuretic and/or PAC

Question 11

What is/are the mainstay of therapy for relieving congestion in the setting of ADHF?

Answer 11

IV loop diuretics furosemide and bumetanide

Question 12

A patient has a hyponatremia with a serum sodium of 125. Do you give a diuretic?

Answer 12

Yes

Question 13

What drug class are PO Tolvaptan (Samsca or Jynarque) and IV Conivaptan (Vaprisol)?
a) Inotropes
b) ARB
c) Vasodilators
d) Vasopressin receptor antagonist

Answer 13

d) Vasopressin receptor antagonist

Question 14

What should you avoid use in the presence of elevated intracranial pressure because it may worsen cerebral edema in this setting? Select all that apply
a) Inotropes
b) Nitroprusside
c) Nitroglycerin
d) Tolvaptan (Samsca or Jynarque)
e) Conivaptan (Vaprisol)

Answer 14

b) Nitroprusside
d) Tolvaptan (Samsca or Jynarque)

Question 15

ADHF: ____________ are not first line because they have an increased risk of mortality compared to ___________.
a) Vasodilators; inotropes
b) Vasopressin receptor antagonists; vasodilators
c) Inotropes; Vasopressin receptor antagonist
d) Inotropes; vasodilators

Answer 15

d) Inotropes; vasodilators

Question 16

T/F: Diuresis and/or direct venodilation are the most appropriate initial therapy for HF subset 2.

Answer 16

True

Question 17

T/F: Combining a loop diuretic with a distal tubule blocker such as oral metolazone, oral hydrochlorothiazide, or IV chlorothiazide will cause an antagonistic effect

Answer 17

False (synergistic)