Exam 4 Heart Failure

Question 1

heart fail with no limitation of physical activity

Answer 1

class I

Question 2

heart fail with slight limitation of physical activity

Answer 2

class II

Question 3

heart fail with limitation of physical activity, asymptomatic at rest

Answer 3

class III

Question 4

heart fail with severe limitation of physical activity, symptomatic at rest

Answer 4

class IV

Question 5

pt. at risk of heart fail, no structural abnormalities

Answer 5

stage A

Question 6

pt. with structural disorders, no symptoms

Answer 6

stage B

Question 7

pt. with symptoms, structural disorders

Answer 7

stage C

Question 8

end stage heart failure

Answer 8

stage D

Question 9

signs heart failure

Answer 9

edema, rales, JVD

Question 10

symptoms heart failure

Answer 10

dyspnea, fatigue, cough

Question 11

cough in heart failure

Answer 11

nocturnal, nonproductive

Question 12

right sided heart failure

Answer 12

peripheral edema, RUQ pain, JVD, ascites

Question 13

left sided heart failure

Answer 13

dyspnea, tachycardia, rales, S3 or S4

Question 14

ejection fraction heart failure

Answer 14

<45% is concerning

Question 15

systolic dysfnxn heart failure

Answer 15

dilated LV

Question 16

diastolic dysfxn heart failure

Answer 16

LV hypertrophy

Question 17

thyroid panel lab in heart failure

Answer 17

hypothyroidism can present as HF, exacerbate HF

Question 18

exacerbating HF

Answer 18

anemia, diabetes, hypothyroidism

Question 19

brain type natriuretic peptide

Answer 19

HF marker, ventricular wall stretching causes release BNP, high BNP = poor outcome

Question 20

Tx HF

Answer 20

ACE inhibitor, B-blocker, diuretic

Question 21

considerations ACE inhibitors

Answer 21

titrate, renal dysfnxn, cough NOT contraindications

Question 22

considerations B-blockers

Answer 22

lol drugs, metoproLOL etc. dose slowly, after ACE inhibitors stable

Question 23

considerations diuretics

Answer 23

loop diuretic preferred, for fluid overload.

Question 24

considerations spironolactone

Answer 24

for pt. with resting dyspnea in last 6 months, spares potassium, hyperkalemia risk

Question 25

considerations digoxin

Answer 25

pt. with A-fib, helps with exercise tolerance

Question 26

ADL

Answer 26

activities of daily living, loss of normal activity = higher mortality

Question 27

drugs that worsen HF

Answer 27

NSAIDs, glucophage, viagra, cialis, levitra, TCA, sporanox, tegretol

Question 28

tell tale sign of pulmonary edema

Answer 28

productive cough with rales, wheezes, rhonchi after a cardiac event (HF, MI, etc)

Question 29

CXR pulmonary edema

Answer 29

kerley B lines, cardiomegaly

Question 30

Tx pulmonary edema and decomp

Answer 30

O2, morphine, diuretic, nitrates

Question 31

most common cause right sided HF

Answer 31

left sided HF

Question 32

most common cause HF

Answer 32

coronary artery disease