22 Questions
What is the recommended therapy that includes ACEi, ARB, ARNI, and MRA?
cRAASi
What type of inhibitor is angiotensin-converting enzyme?
Angiotensin-converting enzyme inhibitor
What is the level of evidence for the 2022 AHA/ACC/HFSA guideline?
Moderate-quality evidence from one or more RCTs and meta-analyses of moderate-quality RCTs
When can ARBs be used?
When intolerant to ACEi or ARNI
What is the abbreviation for angiotensin receptor-neprilysin inhibitor?
ARNI
What is the name of the receptor antagonist mentioned in the content?
Mineralocorticoid receptor antagonist
What type of therapy is included in RAASi therapy?
ACEi, ARNI, and MRA
What is the therapy used if a patient is intolerant to ACEi or ARNI?
ARBs
What is the level of evidence for the recommendation in the 2022 AHA/ACC/HFSA guideline?
Moderate-quality evidence from nonrandomized studies
What is the harm level of the recommendation in the 2022 AHA/ACC/HFSA guideline?
Risk > Benefit
What is the purpose of the KDIGO guidelines?
To provide expert guidance on the care of patients with diabetes
What is the class of the recommendation in the 2022 AHA/ACC/HFSA guideline?
Class 3: Harm
What is the effect of RAASi therapy on renal K+ excretion?
It impairs renal K+ excretion.
Which of the following medications blocks angiotensin II formation?
Direct renin inhibitor
What is the effect of angiotensin II on aldosterone release?
It stimulates aldosterone release.
Which of the following medications blocks aldosterone receptor binding?
Mineralocorticoid receptor antagonist
What is the effect of RAASi therapy on urinary K+ excretion?
It impairs urinary K+ excretion.
Which of the following medications blocks angiotensin II-mediated aldosterone release?
Angiotensin II receptor blocker
What is the effect of aldosterone on potassium homeostasis?
It enhances potassium excretion.
Which of the following medications impairs renal K+ excretion?
All of the above
What is the effect of hyperkalemia on RAASi therapy?
It impairs RAASi therapy.
Which of the following medications blocks the effect of angiotensin II on aldosterone release?
Angiotensin II receptor blocker
Study Notes
RAASi Therapy and Heart Failure
- RAASi therapy includes ACEi, ARNI, and MRA.
- ARBs can be used if intolerant to ACEi or ARNI.
Guidelines and Recommendations
- 2022 AHA/ACC/HFSA guideline: Recommendation (3:Harm B-NR) suggests that RAASi therapy may harm patients with CKD.
- 2022 AHA/ACC/HFSA guideline: Recommendation (2b B-R) suggests that ARBs can be used if intolerant to ACEi or ARNI.
RAAS Inhibition and Hyperkalaemia
- RAAS inhibition impairs renal K+ excretion.
- Direct renin inhibitors and ACEi block angiotensin II formation, leading to impaired aldosterone release and hyperkalaemia.
- ARBs block angiotensin II-mediated aldosterone release, leading to hyperkalaemia.
- MRAs block aldosterone receptor binding, leading to hyperkalaemia.
This quiz covers the guidelines and therapies for heart failure, including RAASi therapy, ARBs, and potassium-lowering agents, as recommended by the 2022 AHA/ACC/HFSA guideline.
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