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

Which medication is recommended for diastolic heart failure treatment?

<p>Digoxin (A)</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 (B)</p> Signup and view all the answers

What is the hallmark finding in dilated cardiomyopathy?

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

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

<p>Echocardiogram (C)</p> Signup and view all the answers

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

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

What population is most commonly affected by stress takotsubo cardiomyopathy?

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

What is the gold standard diagnostic study for myocarditis?

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

What medication is known to cause myocarditis?

<p>Clozapine (B)</p> Signup and view all the answers

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

<p>Myocarditis (A)</p> Signup and view all the answers

What type of heart sound is commonly heard in myocarditis?

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

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

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

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

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

Which infiltrative disease is most commonly associated with restrictive cardiomyopathy?

<p>Sarcoidosis (A)</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 (B)</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 (C)</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 (C)</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 (C)</p> Signup and view all the answers

What is the mainstay of treatment for stress takotsubo cardiomyopathy?

<p>Conservative and supportive care (C)</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 (A)</p> Signup and view all the answers

What is the most common symptom of hypertrophic cardiomyopathy?

<p>Dyspnea (D)</p> Signup and view all the answers

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

<p>Digoxin (D)</p> Signup and view all the answers

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

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

What blood pressure readings indicate elevated blood pressure?

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

What is the most common cause of primary essential hypertension?

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

What is the workup for hypertension?

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

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

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

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

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

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

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

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

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

What should patients with hypertrophic cardiomyopathy (HCM) avoid?

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

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

<p>$15mm$ or greater septal thickness (A)</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 (C)</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 (D)</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 (B)</p> Signup and view all the answers

Which blood pressure readings indicate elevated blood pressure?

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

What is the most common cause of primary essential hypertension?

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

What is the cause of secondary hypertension?

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

What is the blood pressure target for someone with hypertension?

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

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

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

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

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

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

<p>Beta blockers (A)</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 (D)</p> Signup and view all the answers

What is a potential adverse effect of loop diuretics?

<p>Hyperkalemia (B)</p> Signup and view all the answers

What is the definitive diagnosis for restrictive cardiomyopathy?

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

Which adverse effect is associated with potassium sparing diuretics?

<p>Hyperkalemia (B)</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 (D)</p> Signup and view all the answers

What is a common adverse effect of ACE inhibitors?

<p>Angioedema (A)</p> Signup and view all the answers

What is the most common trigger for vasovagal syncope?

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

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

<p>Vasodilators (C)</p> Signup and view all the answers

What is the hallmark symptom of vasovagal syncope?

<p>Dizziness (B)</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 (D)</p> Signup and view all the answers

What is the neurologic cause of postural orthostatic hypotension?

<p>Diabetic neuropathy (C)</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 (D)</p> Signup and view all the answers

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

<p>Echocardiogram (B)</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 (C)</p> Signup and view all the answers

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

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

What is the hallmark finding in stress takotsubo cardiomyopathy?

<p>Coronary artery spasm (C)</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 (D)</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 (D)</p> Signup and view all the answers

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

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

Which echocardiographic finding is characteristic of hypertrophic cardiomyopathy?

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

What should patients with hypertrophic cardiomyopathy avoid?

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

What is the diagnostic criteria for fever?

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

Which medication is first-line management for Prinzmetal angina?

<p>Diltiazem (A)</p> Signup and view all the answers

What symptom characterizes Prinzmetal angina?

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

What should be avoided in the management of Prinzmetal angina?

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

What is the cause of cocaine-induced myocardial infarction?

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

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

<p>Transient ST elevations (A)</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 (D)</p> Signup and view all the answers

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

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

What is the most common cause of myocarditis?

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

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

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

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