Acute Decompensated Heart Failure Quiz
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Questions and Answers

What is the best test for diagnosing congestive heart failure (CHF)?

  • Echo to assess ventricular walls and ejection fraction
  • Chest X-ray showing Kerley B lines
  • BNP levels over 100 (correct)
  • Assessing New York Heart Association functional class

    • Which medication is considered the best for systolic heart failure?

  • ACE inhibitors
  • Spironolactone/eplerenone
  • K+ sparing diuretics
  • Beta blockers (correct)

    • How do Kerley B lines appear on a chest X-ray for heart failure?

  • Pericardial effusion and cardiomegaly
  • Pleural effusion and peripheral edema
  • Bat wing appearance in the periphery of the lungs
  • Ghost white like lines in a triangular area (correct)

    • What is the New York Heart Association functional class 4 for CHF characterized by?

    <p>Symptoms at rest</p> Signup and view all the answers

    Which medication is recommended for diastolic heart failure treatment?

    <p>Digoxin</p> Signup and view all the answers

    Which of the following symptoms is most likely to be present in left-sided heart failure?

    <p>Dyspnea</p> Signup and view all the answers

    What is the hallmark finding in dilated cardiomyopathy?

    <p>S3 gallop</p> Signup and view all the answers

    Which diagnostic test is the preferred choice for evaluating dilated cardiomyopathy?

    <p>Echocardiogram</p> Signup and view all the answers

    What is the most appropriate medication for mortality reduction in dilated cardiomyopathy?

    <p>ACE inhibitors</p> Signup and view all the answers

    What population is most commonly affected by stress takotsubo cardiomyopathy?

    <p>Postmenopausal women</p> Signup and view all the answers

    What is the gold standard diagnostic study for myocarditis?

    <p>End-myocardial biopsy</p> Signup and view all the answers

    What medication is known to cause myocarditis?

    <p>Clozapine</p> Signup and view all the answers

    Which condition presents symptoms similar to those seen in dilated cardiomyopathy?

    <p>Myocarditis</p> Signup and view all the answers

    What type of heart sound is commonly heard in myocarditis?

    <p>S3 gallop</p> Signup and view all the answers

    What is the most common cause of right-sided heart failure?

    <p>Chronic obstructive pulmonary disease (COPD)</p> Signup and view all the answers

    What is the characteristic finding in diastolic dysfunction of restrictive cardiomyopathy?

    <p>Decreased compliance of the ventricle</p> Signup and view all the answers

    Which infiltrative disease is most commonly associated with restrictive cardiomyopathy?

    <p>Sarcoidosis</p> Signup and view all the answers

    Which sign is characteristic of restrictive cardiomyopathy and involves the lack of an inspiratory decline or increase in jugular venous pressure?

    <p>Kussmaul's sign</p> Signup and view all the answers

    What is the diagnostic test of choice for evaluating non-dilated ventricles with normal thickness in restrictive cardiomyopathy?

    <p>Echocardiogram</p> Signup and view all the answers

    What is a characteristic finding on chest radiograph in patients with restrictive cardiomyopathy?

    <p>Normal ventricular chamber size and enlarged atria</p> Signup and view all the answers

    Which condition presents with transient regional left ventricular systolic dysfunction and apical left ventricular ballooning?

    <p>Coronary artery spasm</p> Signup and view all the answers

    What is the mainstay of treatment for stress takotsubo cardiomyopathy?

    <p>Conservative and supportive care</p> Signup and view all the answers

    Which genetic disorder is characterized by inappropriate left ventricular and/or right ventricular hypertrophy with diastolic dysfunction?

    <p>Hypertrophic cardiomyopathy</p> Signup and view all the answers

    What is the most common symptom of hypertrophic cardiomyopathy?

    <p>Dyspnea</p> Signup and view all the answers

    Which medication can worsen obstruction in hypertrophic cardiomyopathy due to increased contractility?

    <p>Digoxin</p> Signup and view all the answers

    What is the main diagnostic test for acute decompensated heart failure?

    <p>Chest X-ray (CXR)</p> Signup and view all the answers

    What is the recommended position for a patient with acute decompensated heart failure to help decrease preload?

    <p>Sitting upright with legs hanging off the table</p> Signup and view all the answers

    What blood pressure readings indicate elevated blood pressure?

    <p>Systolic 120-129, Diastolic &gt;90</p> Signup and view all the answers

    What is the most common cause of primary essential hypertension?

    <p>High salt sensitivity</p> Signup and view all the answers

    What is the workup for hypertension?

    <p>Electrocardiogram (ECG)</p> Signup and view all the answers

    What is a characteristic finding in hypertrophic cardiomyopathy (HCM)?

    <p>Increased LV volume with preserved outflow</p> Signup and view all the answers

    How does hypertrophic cardiomyopathy (HCM) typically present in preadolescent children during extreme exertion?

    <p>Sudden cardiac death due to ventricular fibrillation</p> Signup and view all the answers

    What is the first-line medical management for hypertrophic cardiomyopathy (HCM)?

    <p>Beta blockers</p> Signup and view all the answers

    Which maneuver can lead to increased murmur intensity in hypertrophic cardiomyopathy (HCM)?

    <p>Valsalva maneuver</p> Signup and view all the answers

    What is an alternative to surgical myomectomy for the treatment of hypertrophic cardiomyopathy (HCM)?

    <p>Alcohol septal ablation</p> Signup and view all the answers

    Which of the following ECG findings is consistent with hypertrophic cardiomyopathy (HCM)?

    <p>Left ventricular hypertrophy</p> Signup and view all the answers

    What should patients with hypertrophic cardiomyopathy (HCM) avoid?

    <p>Dehydration and extreme exertion</p> Signup and view all the answers

    What is a potential echocardiographic finding in hypertrophic cardiomyopathy (HCM)?

    <p>$15mm$ or greater septal thickness</p> Signup and view all the answers

    What is a significant difference in the murmur intensity of hypertrophic cardiomyopathy (HCM) when comparing increased and decreased venous return?

    <p>The murmur intensity increases with increased venous return</p> Signup and view all the answers

    What is a potential result of an ECG in patients with hypertrophic cardiomyopathy (HCM)?

    <p>T-wave inversion in leads V1-V3</p> Signup and view all the answers

    What are the common tests used to diagnose acute decompensated heart failure?

    <p>Chest X-ray, BNP test, and echocardiogram</p> Signup and view all the answers

    Which blood pressure readings indicate elevated blood pressure?

    <p>Systolic 120-129 and diastolic 140 or higher</p> Signup and view all the answers

    To be diagnosed with hypertension, what is the requirement for the elevated blood pressure readings?

    <p>Elevations must be recorded on at least two separate visits</p> Signup and view all the answers

    What is the most common cause of primary essential hypertension?

    <p>High salt sensitivity</p> Signup and view all the answers

    What is the cause of secondary hypertension?

    <p>Underlying, correctable cause</p> Signup and view all the answers

    What is the blood pressure target for someone with hypertension?

    <p>Less than 140/90</p> Signup and view all the answers

    For a patient with isolated systolic hypertension, what is the recommended hypertensive therapy?

    <p>Diuretics or CCBs</p> Signup and view all the answers

    What is the initial hypertensive therapy for non-African-American patients with uncomplicated hypertension?

    <p>Thiazide diuretics</p> Signup and view all the answers

    Which medication is recommended for a patient with hypertension and post-myocardial infarction?

    <p>Beta blockers</p> Signup and view all the answers

    What is the preferred hypertensive therapy for a patient with diabetes mellitus or chronic kidney disease?

    <p>ACE inhibitors or ARBs</p> Signup and view all the answers

    What is a potential adverse effect of loop diuretics?

    <p>Hyperkalemia</p> Signup and view all the answers

    What is the definitive diagnosis for restrictive cardiomyopathy?

    <p>Endomyocardial biopsy</p> Signup and view all the answers

    Which adverse effect is associated with potassium sparing diuretics?

    <p>Hyperkalemia</p> Signup and view all the answers

    What is the management choice for postural orthostatic hypotension?

    <p>Conservative initial management with increased salt and fluid intake + fludrocortisone</p> Signup and view all the answers

    What is a common adverse effect of ACE inhibitors?

    <p>Angioedema</p> Signup and view all the answers

    What is the most common trigger for vasovagal syncope?

    <p>Emotional stress/fear</p> Signup and view all the answers

    What is the primary mechanism of action for dihydropyridine calcium channel blockers?

    <p>Vasodilators</p> Signup and view all the answers

    What is the hallmark symptom of vasovagal syncope?

    <p>Dizziness</p> Signup and view all the answers

    How is hypertensive urgency managed?

    <p>Gradual reduction of mean arterial pressure by no more than 25% over 24 to 48 hours</p> Signup and view all the answers

    What is the neurologic cause of postural orthostatic hypotension?

    <p>Diabetic neuropathy</p> Signup and view all the answers

    Which cardiac condition presents with transient regional left ventricular systolic dysfunction and apical left ventricular ballooning?

    <p>Stress takotsubo cardiomyopathy</p> Signup and view all the answers

    What is the main diagnostic test for hypertrophic cardiomyopathy (HCM)?

    <p>Echocardiogram</p> Signup and view all the answers

    Which medication should be avoided in hypertrophic cardiomyopathy (HCM) due to its potential to worsen obstruction?

    <p>Beta agonists</p> Signup and view all the answers

    What is the characteristic symptom of hypertrophic cardiomyopathy (HCM)?

    <p>Angina (chest pain)</p> Signup and view all the answers

    What is the hallmark finding in stress takotsubo cardiomyopathy?

    <p>Coronary artery spasm</p> Signup and view all the answers

    What is the most likely cause of sudden cardiac death in adolescent or preadolescent children during extreme exertion?

    <p>Ventricular fibrillation</p> Signup and view all the answers

    What maneuver is most likely to increase the intensity of the systolic murmur associated with hypertrophic cardiomyopathy?

    <p>Valsalva maneuver</p> Signup and view all the answers

    What is the first-line medical management for hypertrophic cardiomyopathy?

    <p>Beta blockers</p> Signup and view all the answers

    Which echocardiographic finding is characteristic of hypertrophic cardiomyopathy?

    <p>Systolic anterior motion of the mitral valve</p> Signup and view all the answers

    What should patients with hypertrophic cardiomyopathy avoid?

    <p>Extreme exertion</p> Signup and view all the answers

    What is the diagnostic criteria for fever?

    <p>Temperature &gt;38°C (100.4°F)</p> Signup and view all the answers

    Which medication is first-line management for Prinzmetal angina?

    <p>Diltiazem</p> Signup and view all the answers

    What symptom characterizes Prinzmetal angina?

    <p>Chest pain at rest</p> Signup and view all the answers

    What should be avoided in the management of Prinzmetal angina?

    <p>Beta blockers</p> Signup and view all the answers

    What is the cause of cocaine-induced myocardial infarction?

    <p>Coronary artery vasospasm</p> Signup and view all the answers

    Which ECG finding is classic in cocaine-induced myocardial infarction?

    <p>Transient ST elevations</p> Signup and view all the answers

    What drugs are considered the first-line management for cocaine-induced myocardial infarction?

    <p>Calcium channel blockers and nitrates</p> Signup and view all the answers

    What should be avoided in the management of cocaine-induced myocardial infarction?

    <p>Nonselective beta blockers</p> Signup and view all the answers

    What is the most common cause of myocarditis?

    <p>Viral infection</p> Signup and view all the answers

    Which of the following is a characteristic ECG finding in myocarditis?

    <p>ST-segment elevations</p> Signup and view all the answers

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