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Questions and Answers
What effect does sympathetic activation have on heart rate?
Which of the following best describes the effect of sympathetic activation on cardiac contractility?
What physiological change occurs as a result of venoconstriction during sympathetic activation?
Which statement about sympathetic activation is incorrect?
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How does sympathetic activation affect venous blood flow?
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What is the primary goal of using diuretics in patients experiencing volume overload?
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Which of the following diuretics is commonly used first-line for volume overload management?
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Which diuretic can be considered as an alternative when furosemide is not effective?
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Which of the following thiazide-like diuretics can be used for the management of volume overload?
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What types of symptoms might indicate the need for diuretic treatment?
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What causes backward symptoms and signs in heart failure?
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Which type of congestion is associated with left side heart failure?
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In right side heart failure, which condition is primarily indicated?
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What is the result of pulmonary venous congestion?
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Backward symptoms and signs are primarily a result of which physiological issue?
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What condition is associated with arrhythmia as a common symptom?
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Which of the following is NOT a part of the T-F-A-I-L-E mnemonic?
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What is the significance of 'I' in the T-F-A-I-L-E mnemonic?
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Which endocrine issue is mentioned in the T-F-A-I-L-E mnemonic?
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What can failure to take medication lead to as indicated in the T-F-A-I-L-E mnemonic?
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What is the effect of daytime activities on kidney blood flow in heart failure patients?
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What is nocturia, and why does it occur in heart failure patients during bed rest?
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What is oliguria, and how is it defined in the context of kidney function?
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Why does bed rest serve as a diuretic for patients with heart failure?
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What physiological change occurs in patients with heart failure leading to daytime oliguria?
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Study Notes
Heart Failure Management
- Loop diuretics are commonly used to relieve symptoms of volume overload such as dyspnea and peripheral edema.
- Furosemide (Lasix) is the most commonly used loop diuretic.
- Other options include bumetanide (Bumex) and torsemide.
- Thiazide-like diuretics such as metolazone and chlorothiazide can also be used.
- The acronym "T-F-A-I-L-E" helps remember potential causes of worsening heart failure:
- Thyrotoxicosis
- Failure to take medication
- Arrhythmia (common)
- Infection (especially chest infections), Ischemia (common)
- Lung problems
- Endocrine (phaeochromocytoma, DM)
- Sympathetic activation in heart failure leads to:
- Increased heart rate (chronotropy)
- Increased contractility (inotropy)
- Increased preload due to venoconstriction, which drives more blood back to the heart.
- Backward symptoms and signs occur as a result of blood congestion in the venous system.
- Pulmonary venous congestion (P.V.C) occurs in left-sided heart failure.
- Systemic venous congestion (S.V.C) occurs in right-sided heart failure.
- Kidney function is affected in heart failure:
- Daytime oliguria (reduced urine output) and nocturia (increased urination at night) are common.
- Limited cardiac output during daily activity shifts blood flow from kidneys to skeletal muscles, leading to decreased renal blood flow (oliguria < 30ml/hr).
- At rest, blood flow shifts from relaxed skeletal muscles back to the kidneys, leading to an increase in nocturnal urine production.
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Description
This quiz covers essential aspects of managing heart failure, focusing on the role of loop and thiazide-like diuretics. It includes memory aids for recognizing causes of worsening heart failure and discusses the physiological response in sympathetic activation. Test your understanding of these crucial concepts in cardiac care.
