Congestive Cardiac Failure

Question 1

Cardiomegaly, batwings and interstitial fluid are a sign of which-sided heart failure?

Answer 1

Left

Question 2

Oedema (ankle/sacral), Hepatomegaly, elevated JVP and ascites are a sign of which sided heart failure?

Answer 2

Right

Question 3

Why should you reduced digoxin dose in renal impairment?

Answer 3

Because it is excreted slowly by the kidneys

Question 4

Acute LVF therapy

Answer 4

Sit up
Oxygen (careful in COPD)
IV frusemide
IV diamorphine (not in COPD)

Question 5

When should you not give diuretics?

Answer 5

Gout

Question 6

Thiazide diuretics for mild or severe heart failure only?

Answer 6

Mild

Question 7

If you’re giving a diuretic, what drugs could help to normalise K+?

Answer 7

ACE inhibitor

Spironolactone

Question 8

Side effects of spironolactone?

Answer 8

Gynaecomastia
Renal dysfunction
Hyperkalemia

Question 9

Why would you give ivabradine in heart failure?

Answer 9

If the heart rate is still really fast despite the beta blockers (i.e if the beta blockers doing the job well enough)