HF Treatment

Background/Risk Factors

100

What besides HF can cause elevated BNP levels? (select all that apply)

a. Obesity

b. Renal failure

c. Diabetes Mellitus

d. Bacterial Sepsis

B & D

renal failure and bacterial sepsis 

200

What is the normal ejection fraction?

55 - 70%

300

What are classification system is focused on symptoms?

NYHA Functional Class

400

What is NOT a common cause of HF?

a. MI

b. HTN

c. Chronic methamphetamine use

d. Valvular Heart Disease

C. chronic methamphetamine use

500

Which patient population has the highest death rate per capita resulting from HF?

a. Hispanic patients

b. Caucasian patients

c. Non-Hispanic black patients

d. Asian/Pacific Islander patients

C. Non-Hispanic black patients

Medication Classes

100

Which beta blocker CAN be used in HF?

a. Metoprolol tartrate

b. Nadolol

c. Metoprolol succinate 

d. propranolol

C. Metoprolol succinate

200

Preferred class of diuretics for those with HF

Loop diuretics

300

How do you switch a patient from an ACE inhibitor to an ARNI?

36 hour washout

400

Which classes of medications worsen HF? (select all that apply)

a. Class 1C antiarrhythmics

b. Dihydropyridine CCBs

c. DPP4 Inhibitors

d. Thiazolidinediones 

A, C, & D

Class 1C antiarrhythmics, DPP4 inhibitors, TZDs

500

Target dose for sacubitril/valsartan (Entresto)

a. 49/51 mg BID

b. 24/26 mg BID

c. 97/103 mg BID

d. 73/77 mg BID

C - 97/103 mg BID

Special Populations

100

In what patient population can hydralazine/nitrates be beneficial in?

African American

200

True or False

Ivabradine (Corlanor) can be used in patients with HFpEF who are in sinus rhythm with HR >/= 90 bpm

False

stable HFrEF who are in sinus rhythm with HR > 70 bpm

300

A patient presented with Acute Decompensated HF and you want to start them on IV diuretics - how do you determine the dose if they were already on furosemide at home?

Dose should be equivalent to or higher than home PO dose (1 - 2.5x home dose)

400

True or False:

Digoxin can be used in patients with symptomatic HFrEF despite GDMT to reduce mortality

FALSE

reduces hospitalizations

500

What class of medications reduce mortality in those with Stage B HF with history of MI and LVEF < 40%?

a. Non-dihydropyridine CCBs

b. Beta Blockers

c. Diuretics

d. Inotropes

B. beta blockers

Monitoring

100

True or False

When starting a patient on an ACE inhibitor, SCr can transiently double for the first 4-6 weeks of treatment.

False.

ACE inhibitors should be discontinued if the increase in SCr is over 30% from baseline

200

Target serum level for digoxin is what?

0.5 to < 0.9 ng/mL

300

Which agent requires a pregnancy test prior to initiation?

a. ivabradine

b. digoxin

c. vericiguat

d. lisinopril

c. vericiguat

400

Signs and symptoms of digoxin toxicity include all the following EXCEPT:

a. Vomiting

b. Hypoglycemia

c. Vision changes

d. Cardiac arrhythmias

B. hypoglycemia

500

What must be performed two weeks after starting ivabradine?

EKG