MedGard Congestive Heart Failure Quiz

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Questions and Answers

Which agent has been demonstrated to reduce mortality in patients with congestive heart failure?

Procainamide

Furosemide

Enalapril (correct)

Digitalis

What is a recognized side effect of furosemide in the treatment of congestive heart failure?

Hypokalaemia

Haemolytic anaemia (correct)

Bronchospasm

Hypoglycaemia

In a patient with regular narrow complex tachycardia, under which condition should the dose of adenosine be reduced?

Significant mitral regurgitation

Theophylline use

Chronic renal impairment

Dipyridamole use (correct)

Which drug used for chronic heart failure has been associated with increased survival?

Enalapril Signup and view all the answers

What is the most likely diagnosis for a patient with a systolic murmur and splenomegaly after a dental procedure?

Bacterial endocarditis Signup and view all the answers

What type of angina is characterized by chest pain that occurs at rest and lasts longer than previously experienced?

Unstable angina Signup and view all the answers

Which symptom is most closely associated with digoxin toxicity?

Visual disturbances Signup and view all the answers

For a hemodynamically stable patient undergoing treatment for narrow complex tachycardia, which condition does not require a dose adjustment of adenosine?

Cardiac transplant Signup and view all the answers

What is the most appropriate medication for a patient with a dilated left ventricular chamber and an ejection fraction of 30%?

Spironolactone Signup and view all the answers

Which vitamin supplement is essential for a patient on isoniazid therapy to prevent neuropathy?

Pyridoxine Signup and view all the answers

What is the likely reason for elevated TSH levels in a patient receiving increased thyroxine?

Poor medication adherence Signup and view all the answers

What might be the cause of intense flushing after taking a newly prescribed lipid-lowering drug?

Vasodilatory effect Signup and view all the answers

In the management of hypertension, which medication was recommended after a drug change due to side effects?

High-dose aspirin Signup and view all the answers

What is the most likely diagnosis for a patient presenting with an ankle-brachial index of 0.80?

Chronic limb ischemia Signup and view all the answers

Which condition must be excluded before allowing a 15-year-old boy to participate in sports given his family history of sudden cardiac death?

Hypertrophic cardiomyopathy Signup and view all the answers

What is the most likely diagnosis for a 55-year-old diabetic patient experiencing bilateral intermittent leg pain relieved by rest?

Peripheral arterial disease Signup and view all the answers

In a patient with left-sided hemiparesis and confirmed brain infarction, what is the best management option?

Aspirin Signup and view all the answers

Given a patient with bilateral leg deep vein thrombosis and prolonged APTT, what is the most likely diagnosis?

Antiphospholipid syndrome Signup and view all the answers

What is the most likely diagnosis for an 81-year-old diabetic presenting with a cold lower extremity and diminished pedal pulses?

Arterial insufficiency Signup and view all the answers

What underlying condition should be considered in a 70-year-old man with acute confusional state, postural hypotension, and dry mucous membranes?

Dehydration Signup and view all the answers

In a scenario where a diabetic patient's leg pain worsens in a dependent position, what is the most likely diagnosis?

Arterial obstruction Signup and view all the answers

What is the most appropriate management modification for a patient with hypertension currently treated with hydrochlorothiazide?

Add an angiotensin converting enzyme inhibitor Signup and view all the answers

What is the most likely diagnosis for a patient presenting with fever, night sweats, and painless erythematous lesions on the palms?

Bacterial endocarditis Signup and view all the answers

In a 77-year-old woman with dizziness when standing up, what is the most likely explanation for her symptoms?

Autonomic neuropathy Signup and view all the answers

What is the most appropriate next step in management for a patient with confusion and low blood pressure due to acute illness?

IV boluses of normal saline Signup and view all the answers

Which abnormal lab result would indicate a potential complication in a patient with poorly controlled diabetes?

Glucose, fasting 7.3 mmol/L Signup and view all the answers

What physical examination finding is a common indicator of bacterial endocarditis?

Painless erythematous lesions Signup and view all the answers

In assessing a 67-year-old man with confusion and tachycardia, which of the following is the most likely vital sign abnormality?

Heart rate 120/min Signup and view all the answers

What class of medications is commonly contraindicated in patients with autonomic neuropathy?

Beta blockers Signup and view all the answers

Based on the symptoms experienced in the Emergency Department, what is the most likely diagnosis?

Unstable angina Signup and view all the answers

After the initial management in the Emergency Department for the 65-year-old woman, what is the most appropriate treatment?

Primary coronary artery stenting Signup and view all the answers

For the 75-year-old man with atrial fibrillation and a previous transient ischemic attack, what is the most appropriate management plan?

Start anticoagulation therapy to prevent stroke Signup and view all the answers

What is the most likely diagnosis for the 29-year-old woman with shortness of breath after giving birth?

Peripartum cardiomyopathy Signup and view all the answers

What is the most likely cause of sudden dyspnoea and a new harsh systolic murmur in a man 6 days after a myocardial infarction?

Ruptured aortic cusp Signup and view all the answers

What ECG finding is typically associated with unstable angina?

ST segment depression Signup and view all the answers

Which symptom is least likely to be associated with peripartum cardiomyopathy?

Frothy sputum Signup and view all the answers

Which treatment option is inappropriate for a patient with myocardial infarction?

Intensive insulin therapy Signup and view all the answers

Study Notes

Congestive Heart Failure

Furosemide is identified as an agent that reduces mortality in patients with congestive heart failure.
Recognized side effect of furosemide: haemolytic anaemia.
Enalapril has been shown to increase survival in chronic heart failure treatment.

Digoxin Toxicity

Symptoms: vomiting, abdominal pain, yellow-tinged vision.
Most likely diagnosis in a 40-year-old woman presenting with these symptoms is digoxin toxicity.

Regular Narrow Complex Tachycardia

In hemodynamically stable patients receiving IV adenosine, dosage should be reduced in the presence of dipyridamole.

Bacterial Endocarditis

Most likely diagnosis for a 39-year-old man presenting with fever, splenomegaly, and elevated WBC is bacterial endocarditis.
Symptoms and findings suggest infective endocarditis associated with recent dental procedures.

Angina Types

Unstable angina is characterized by worsening chest pain, occurring at rest or with minimal exertion.

Hypertension Management

In a 52-year-old man with poorly controlled hypertension on hydrochlorothiazide, adding an angiotensin-converting enzyme (ACE) inhibitor is the most appropriate management modification.

Infective Endocarditis Indicators

An intravenous drug user with symptoms of fever, night sweats, and retinal findings is suggested to have bacterial endocarditis.

Autonomic Neuropathy

A 77-year-old woman showing orthostatic dizziness is likely experiencing symptoms due to autonomic neuropathy rather than medication side effects or hypoglycemia.

Diagnostic Management

In a case of suspected unstable angina, IV boluses of normal saline should be the immediate management step.

Acute Limb Ischemia

Diagnosis for a patient with cold, red, and diminished pulses in the leg is likely arterial insufficiency.

Cardiac Event Management

A patient showing ST segment depression may present with unstable angina, requiring appropriate management.

Thrombolytic Therapy

Primary coronary artery stenting is indicated for a patient presenting with rapid onset shortness of breath and arm pain.

Atrial Fibrillation Management

For an asymptomatic 75-year-old man with atrial fibrillation, starting anticoagulation therapy is crucial to prevent stroke.

Peripartum Cardiomyopathy

A postpartum woman exhibiting difficulty breathing and a displaced apex beat is likely suffering from peripartum cardiomyopathy.

Myocardial Complications

A patient post-myocardial infarction with dyspnea and new heart murmur may be developing functional mitral regurgitation.

Medication and Neuropathy

Pyridoxine administration is recommended for a patient on isoniazid to prevent neuropathy.

Hypothyroidism and Lab Results

Poor medication adherence in a 30-year-old woman is suggested by lab results that indicate mismanaged thyroid levels.

Lipid Management Reaction

Faced with intense flushing from a prescribed lipid medication, patient relief was achieved by converting to a higher dose of aspirin rather than the initially prescribed lower dose.

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Description

Test your knowledge on the management of congestive heart failure with this quiz. It covers key agents used in treatment and their effects. Ensure you understand the role of medications like furosemide and their side effects.