Oral Exam: HF

Question 1

HFrEF treatment overview

Answer 1

All patients: ACE/ARB + BB (if stable)
If fluid overload: diuretic
If African American: consider hydralazine
If EF /< 35%: aldosterone antagonist

Question 2

HFrEF ACE target dose

Answer 2

Lisinopril 20mg daily

Question 3

ACE monitoring

Answer 3

Hyperkalemia
Renal decline
Cough
Angioedema
Hypotension

Question 4

HFrEF ARB target dose

Answer 4

Losartan 150mg daily

Question 5

ARB monitoring

Answer 5

Hyperkalemia
Renal decline
Cough
Angioedema
Hypotension

Question 6

HFrEF Diuretic target dose

Answer 6

Furosemide 240mg daily

Question 7

Furosemide monitoring

Answer 7

Hypokalemia

Hypotension

Question 8

HFrEF BB target doses

Answer 8

Carvedilol 25mg BID

Metoprolol succinate 200mg QD

Question 9

BB monitoring

Answer 9

Fatigue
BP
HR

Question 10

HFrEF Aldosterone antagonist target dose

Answer 10

Spironolactone 25mg QD

Question 11

ADHF “warm and wet” treatment

Answer 11

Lasix IV

Double PO dose and add a little

Question 12

ADHF “cold and wet” treatment

Answer 12

Inotrope or Vasodilator
+
Lasix

Question 13

Considered wet when:

Answer 13

PCWP > 15-18

Question 14

ADHF “cold and dry” treatment

Answer 14

(May need fluids)

Inotrope or Vasodilator

Question 15

ADHF Vasodilator dose

Answer 15

Nitroprusside 1mcg/kg/min

Question 16

Nitroprusside monitoring

Answer 16

BP
Thiocyanate/cyanide
Disorientation
CrCl

Question 17

ADHF diuretic monitoring

Answer 17

BP
Fluid loss
Hypokalemia