CHRONIC HEART FAILURE

Question 1

WHAT EF INDICATES SYSTOLIC DYSFUNCTION

Answer 1

EF < 40%

Question 2

SYSTOLIC HEART FAILURE IS ALSO KNOWN AS

Answer 2

HF REDUCED EF
HFrEF

Question 3

ACC/AHA STAGING SYSTEM FOR HF

Answer 3

A AND B INDICATE NO PHYSICAL SYMPTOMS OF HF
C AND D INDICATE SYMPTOMS PRESENT, D BEING MORE SEVERE

Question 4

NYHA FUNCTIONAL CLASS FOR HF

Answer 4

1-4
1 INDICATING NO LIMITATIONS TO PHYSICAL ACTIVITY
4 INDICATING SYMPTOMS PRESENT EVEN AT REST

Question 5

WHICH LABS/BIOMARKERS ARE IDENTIFIED IN HF

Answer 5

BNP
NT-proBNP

Question 6

CARDIAC OUTPUT DEPENDS ON?

Answer 6

HR AND SV
CO = HR X SV

Question 7

WHAT COMPENSATORY MECHANISMS OCCUR DUE TO HF? (TARGET SYSTEMS FOR HF)

Answer 7

SNS
RAAS
VASOPRESSIN
NATRIURETIC PEPTIDES

Question 8

RAAS AND VASOPRESSIN ACTIVITY IN HF

Answer 8

ANGIOTENSIN II CAUSES VASOCONSTRICTION
ALDOSTERONE CAUSES NA AND H2O RETENTION
VASOPRESSIN CAUSES VASOCONSTRICTION AND H2O RETENTION

Question 9

NATURAL PRODUCTS FOR HF

Answer 9

FISH OILS
HAWTHRON
COQ10

Question 10

DRUGS THAT CAN WORSEN HF

Answer 10

DRUG INFORMATION NATION
DPP4 INHIBITORS
IMMUNOSUPPRESSANTS
NON DHP CCB
ANTIARRHYTHMICS
THIAZOLIDINEDIONES
ITRACONAZOLE
ONCOLOGY
NSAIDS

Question 11

WHICH MEDICATION CLASSES ARE RECOMMENDED FOR ALL PATIENTS W/OUT CONTRAINDICATIONS

Answer 11

ACEi, ARB, ARNI
BB
LOOP DIURETICS

Question 12

WHICH MEDICATION CLASSES DECREASE MORTALITY IN HF

Answer 12

RAAS MEDICATIONS
BB
ARA
SGLT2

Question 13

WHICH MEDICATION CLASSES ARE ADDED ON IN SELCT PATIENTS?

Answer 13

ARA
SGLT2
HYDRALAZINE AND NITRATES
IVABRADINE

Question 14

WHEN IS ARA ADDED ON TO INITIAL HF THERAPY?

Answer 14

NYHA CLASS II - IV

Question 15

WHEN IS SGLT2 INHIBITORS ADDED ON TO INITIAL HF THERAPY?

Answer 15

NYHA CLASS II - IV
W/ OR W/OUT DIABETES

Question 16

WHEN IS HYDRALAZINE AND NITRATES ADDED ON TO INITIAL THERAPY?

Answer 16

PERSISTENTLY SYMPTOMATIC BLACK PATIENTS WITH NYHA CLASS III - IV DESPITE TREATMENT WITH ARNI, BB, ARA, SGLT2

Question 17

WHEN IS IVABRADINE ADDED ON TO INITIAL THERAPY

Answer 17

NYHA CLASS II - III IN NORMAL SINUS RHYTHM W/ RESTING HR ≥ 70 BPM ON MAX TOLERATED DOSE OF BB

Question 18

WHAT BENEFIT WOULD DIGOXIN BRING TO HF TREATMENT

Answer 18

SMALL INCREASE IN CO
IMPROVE SX AND ↓ CARDIAC HOSPITALIZATIONS

Question 19

WHICH LOOP DIURETICS ARE INDICATED IN HF

Answer 19

FUROSEMIDE
BUMETANIDE
TORSEMIDE
ETHACRYNIC ACID

Question 20

WHAT IS THE PURPOSE OF LOOP DIURETICS IN HF THERAPY

Answer 20

SYMPTOM CONTROL
DOES NOT IMPROVE SURVIVAL

Question 21

WHAT ALLERGY TO LOOK OUT FOR BEFORE USING LOOP DIURETICS

Answer 21

SULFA ALLERGY
EXCEPT ETHACRYNIC ACID

Question 22

LOOP DIURETIC SIDE EFFECTS

Answer 22

↓K, MG, NA, CL, CA
↑ HCO3, UA, BG, TG, TC
OTOXICITY
PHOTOSENSITIVITY

Question 23

WHICH LOOP DIURETIC HAS THE HIGHEST CHANCE OF OTOTOXICITY

Answer 23

ETHACRYNIC ACID

Question 24

ORAL EQUIVALENT DOSES FOR LOOP DIURETICS

Answer 24

FUROSEMIDE 40
TORSEMIDE 20
BUMETANIDE 1
ETHACRYNIC ACID 50

Question 25

FUROSEMIDE IV:PO RATIO

Answer 25

IV 1 : PO 2

Question 26

BUMETANIDE IV:PO RATIO

Answer 26

1:1

Question 27

ETHACRYNIC ACID RATIO

Answer 27

1:1

Question 28

WHAT IS CAPTOPRIL'S DOSING FREQUENCY

Answer 28

TID

Question 29

WHAT IS THE TARGET DOSE FOR ENALAPRIL

Answer 29

10 - 20 MG BID

Question 30

WHAT IS THE TARGET DOSE FOR LISINOPRIL

Answer 30

20 - 40 MG QD

Question 31

WHAT IS THE TARGET DOSE FOR QUINAPRIL

Answer 31

20 MG BID

Question 32

WHAT IS THE TARGET DOSE FOR RAMIPRIL

Answer 32

10 MG QD

Question 33

WHAT IS THE WASHOUT PERIOD FOR ACEi BEFORE USING ENTRESTO

Answer 33

36 HOURS

Question 34

WHAT IS THE TARGET DOSE FOR LOSARTAN

Answer 34

50 - 150 MG QD

Question 35

WHAT IS THE TARGET DOSE FOR VALSARTAN

Answer 35

160 MG BID

Question 36

WHAT IS THE WASHOUT PERID FOR ARBs BEFORE USING ENTRESTO

Answer 36

NONE

Question 37

WHICH BB ARE INDICATED FOR HF

Answer 37

METOPROLOL SUCCINATE BISOPROLOL CARVEDILOL

Question 38

WHEN WOULD BB BE DISCONTINUED?

Answer 38

ONLY DURING ACUTE DECOMPENSATED HF IF HYPOTENSION OR HYPOPERFUSION IS PRESENT

Question 39

WHAT IS THE TARGET DOSE FOR METOPROLOL SUCCINATE

Answer 39

200 MG QD

Question 40

WHAT IS THE TARGET DOSE FOR CARVEDILOL IR

Answer 40

< 85 KG = 25 MG BID > 85 KG = 50 MG BID

Question 41

WHAT IS THE TARGET DOSE FOR CARVEDILOL CR

Answer 41

80 MG QD

Question 42

METOPROLOL SUCCINATE IV:PO RATIO

Answer 42

1 : 2.5

Question 43

WHAT IS THE TARGET DOSE FOR SPIRONOLACTONE

Answer 43

25 MG DAILY OR BID

Question 44

WHICH SGLT2s ARE INDICATED IN HF

Answer 44

DAPAGLIFLOZIN EMPAGLIFLOZIN

Question 45

WHEN WOULD SGLT2s NOT BE INITIATED

Answer 45

DAPA = eGFR < 30 EMPA = eGFR < 20

Question 46

WHAT IS THE THERAPEUTIC RANGE FOR DIGOXIN IN HF

Answer 46

0.5 - 0.9

Question 47

WHAT IS THE TYPICAL DIGOXIN DOSE IN HF

Answer 47

0.125 - 0.25 MG DAILY

Question 48

AT WHAT CRCL WOULD DOSE ADJUSTMENTS BE NEEDED?

Answer 48

CRCL < 50 EITHER ↓ DOSE OR FREQUENCY

Question 49

WHAT ARE THE SIGNS OF DIGOXIN TOXICITY

Answer 49

INITIAL: N/V, LOSS OF APPETITE, BRADYCARDIA SEVERE: BLURRED/DOUBLE VISION, GREENISH-YELLOW HALOS

Question 50

DIGOXIN ANTIDOTE

Answer 50

DIGIFAB

Question 51

IVABRADINE TARGET HR

Answer 51

BETWEEN 50 - 06 BPM

Question 52

IVABRADINE WARNINGS

Answer 52

BRADYCARDIA ↑ RISK FOR QT PROLONGATION ↑ RISK FOR AFIB

Question 53

WHAT ARE THE CONVERSIONS FOR POTASSIUM CHLORIDE ORAL SOLUTIONS

Answer 53

10% = 20 mEq / 15 mL 20% = 40 mEq / 15 mL

Question 54

WHAT ARE THE HEMODYNAMIC EFFECTS OF DIGOXIN

Answer 54

POSITIVE INOTROPE (INCREASE CONTRACTION FORCE) NEGATIVE CHRONOTROPE (DECREASE HR)

Question 55

WHAT IS THE MOA OF CARVEDILOL

Answer 55

NON SELECTIVE BB BETA 1, BETA 2, ALPHA 1 BLOCKER

Question 56

ONE SHOULD NOTIFY THEIR DOCTOR WHEN THEIR WEIGHT CHANGE IS...

Answer 56

3 - 5 LBS INCREASE WITHIN A WEEK 2 - 4 LBS INCREASE WITHIN A DAY

Question 57

WHAT ARE THE BRAND NAMES FOR POTASSIUM CHLORIDE CAPSULE PRODUCTS

Answer 57

KLOR-CON SPRINKLE MICRO-K