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?

    <p>Enalapril</p> 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?

    <p>Bacterial endocarditis</p> 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?

    <p>Unstable angina</p> Signup and view all the answers

    Which symptom is most closely associated with digoxin toxicity?

    <p>Visual disturbances</p> 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?

    <p>Cardiac transplant</p> 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%?

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

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

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

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

    <p>Poor medication adherence</p> Signup and view all the answers

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

    <p>Vasodilatory effect</p> Signup and view all the answers

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

    <p>High-dose aspirin</p> Signup and view all the answers

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

    <p>Chronic limb ischemia</p> 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?

    <p>Hypertrophic cardiomyopathy</p> 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?

    <p>Peripheral arterial disease</p> Signup and view all the answers

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

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

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

    <p>Antiphospholipid syndrome</p> 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?

    <p>Arterial insufficiency</p> 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?

    <p>Dehydration</p> 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?

    <p>Arterial obstruction</p> Signup and view all the answers

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

    <p>Add an angiotensin converting enzyme inhibitor</p> 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?

    <p>Bacterial endocarditis</p> 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?

    <p>Autonomic neuropathy</p> 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?

    <p>IV boluses of normal saline</p> Signup and view all the answers

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

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

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

    <p>Painless erythematous lesions</p> 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?

    <p>Heart rate 120/min</p> Signup and view all the answers

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

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

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

    <p>Unstable angina</p> 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?

    <p>Primary coronary artery stenting</p> 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?

    <p>Start anticoagulation therapy to prevent stroke</p> 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?

    <p>Peripartum cardiomyopathy</p> 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?

    <p>Ruptured aortic cusp</p> Signup and view all the answers

    What ECG finding is typically associated with unstable angina?

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

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

    <p>Frothy sputum</p> Signup and view all the answers

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

    <p>Intensive insulin therapy</p> 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.

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