CHF

Question 1

diagnostic tests for CHF

Answer 1

12 lead EKG, screen for hemochromatosis (too much iron absorbstion) or HIV, r/o RA, pheochromocytoma (only if indicated), BNP

Question 2

If patient presents with new symptoms of HF in the office what non invasive cardiac imaging should you order?

Answer 2

Xray, echo, repeat measurement of EF to monitor any structural remodeling

Question 3

Should routine repeat measurement of LV function assessment in the absence of clinical status or treatment intervention be preformed?

Answer 3

no

Question 4

What medications should be on board with all patients with a recent or remote history of MI or ACS and reduced EF

Answer 4

ACE inhibitors or ARB if they are allergic to ACE except if they get angioedema from an ACE and statins should be used

Question 5

what med should be used in all patients with a reduced EF to prevent symptomatic HF, even if they do not have a history of MI.

Answer 5

ACE inhibitors

Question 6

nondihydropyridine calcium channel blockers examples

Answer 6

verapamil and diltiazem. They cause less vasodilation and more cardiac depression than other dihydropyridine CCBs

Question 7

what medications may be harmful in asymptomatic patients with low LVEF and no symptoms of HF after an MI

Answer 7

nondihydropyridine calcium channel blockers

-Verapamil and diltiazem

Question 8

bisoprolol, carvedilol, and sustained-release metoprolol succinate are used for what

Answer 8

recommended for all patients with current or prior symptoms of HFrEF

Question 9

Aldosterone receptor antagonists (Spironolactone) are recommended when a patient has an EF of what? or has a hx of diabetes

Answer 9

<40%

Question 10

What should the creatine be in women and men to give a Aldosterone receptor antagonist (Spironolactone)? and what should potassium be? What should GFR be? Anything greater than this could cause harm

Answer 10

men: <2.5
women <2

Potassium: <5
GRF >30

Question 11

what can be given instead of an ACE or ARB when they are contraindicated who are symptomatic of HF?

Answer 11

hydralazine and isosorbide dinitrate

Question 12

Are Statins beneficial as adjunctive therapy when prescribed solely for HF

Answer 12

No

Question 13

Are Calcium channel blocking drugs recommended as routine in HFrEF?

Answer 13

no

Question 14

Usual Water restriction

Answer 14

1/5L-2L/day

Question 15

What should BP be with patients who have HTN and HF?

Answer 15

<130/80