Avoid Me
Watch Me
Stage Me
Define Me
Save Me
100
This class of medication can exacerbate heart failure due to inotropic effects on the heart
What is Non-DHP Calcium Channel Blockers and/or Antiarrythmics
100
This electrolyte related side effect is associated with aldosterone antagonists, ACE inhibitors, ARBs, and ARNI.
What is Hyperkalemia
100
CD is an 81 year old African American female who presents to her doctor’s office with a chronic dry, “hacking” cough, shortness of breath and fatigue. She also mentions she has gained about 7 lbs in the past week. She hasn’t been able to sleep for the past few nights due to her cough and wants an antibiotic to treat it. She is able to perform all functions of daily living on her own with minimal limitation. Her past medical history includes heart failure, diabetes, osteoporosis, and recurrent urinary tract infection. Her home medications are lisinopril, metoprolol succinate, furosemide, metformin, insulin glargine, alendronic acid, vitamin D with calcium, and naproxen as needed for back pain. How would you classify this patient’s heart failure? (AHA and NYHA)
What is AHA Stage C, NYHA Class II
100
True or False: Heart failure with preserved ejection fraction, also known as, diastolic heart failure, is defined by an ejection fraction of ≥ 40%
What is False
100
This HF stage has the most evidence for reduction in morbidity and mortality with the use of pharmacological agents?
What is Stage C
200
In patients with heart failure, acetaminophen would be a safer alternative than this class of medication for pain relief due to the risk of worsening edema and causing an exacerbation of heart failure.
What is NSAIDs
200
A minimum of this many hours must pass between the last dose of ACE-Inhibitor and the first dose of Entresto.
What is at least 36 hours
200
Treatment focusing on hypertension control, symptom relief with diuretics, and/or aldosterone antagonists in select patients is for this type of heart failure.
What is HFpEF
200
The 2016 update to the heart failure guidelines recommends that sacubitril/valsartan can be used as an alternative to an ACEI or ARB first line therapy. If your patient is currently taking enalapril and metoprolol succinate, what would be an appropriate initial dose?
What is Entresto 49 mg/51 mg
200
These three beta blockers have been proven to reduce mortality in heart failure.
What is Metoprolol succinate (Toprol®), carvedilol (Coreg®), bisoprolol (Zebeta®)
300
Corlanor is contraindicated in patients with a HR of __ prior to treatment.
What is <60 bpm
300
Which of the following medications are matched with the appropriate side effect? Eplerenone – Hypokalemia Bisoprolol – Hypertension Digoxin – Angioedema Spironolactone – Gynecomastia Torsemide – Fluid retention
What is Spironolactone
300
A 55 year old Hispanic man has NYHA class II non-ischemic heart failure caused by long-standing uncontrolled hypertension. The patient’s current drug regimen includes furosemide 20 mg orally twice daily and lisinopril 10 mg orally once daily. The patient is being referred to the heart failure specialty clinic due to shortness of breath with moderate exertion. Which one of the following drugs, if added to his current regimen, would be most likely to reduce all-cause mortality? A. Sacubitril/valsartan 24 mg/26 mg orally twice daily B. Losartan 25 mg orally daily C. Carvedilol 3.125 mg orally twice daily D. Digoxin 0.125 mg orally daily E. Milrinone 50 mcg/kg IV over 10 minutes
What is C: Carvedilol 3.125 mg orally twice daily
300
Which of the following is the correct mechanism of action of the ACEI? A. ACEI promote vasodilation through competitive antagonism at the angiotensin (AT1) receptors B. ACEI produce a decrease in blood pressure by blocking beta-1 receptors in the heart C. ACEI decrease heart rate by blocking the sodium/potassium ATPase pump at the potassium binding site D. ACEI create diuresis by binding to the sodium-potassium exchange site on the distal tubules ACEI produce vasodilation by preventing conversion of angiotensin I to angiotensin II
What is D: ACEI create diuresis by binding to the sodium-potassium exchange site on the distal tubules ACEI produce vasodilation by preventing conversion of angiotensin I to angiotensin II
300
AH is a 45 year old female, currently prescribed eplerenone, lisinopril, furosemide, and metoprolol succinate for her AHA Stage C chronic heart failure. Which of her medications has not been proven to reduce her risk of mortality? Eplerenone Lisinopril Furosemide Metoprolol succinate All of her medications
What is furosemide (loop diuretics)
400
DZ is a 55 year old male who is newly diagnosed with diabetes mellitus type 2. He has a past medical history of gout, hypertension, obesity, and systolic heart failure with reduced ejection fraction. The physician should avoid prescribing this class of antidiabetic medication due to his history of heart failure?
What is TZD
400
GL is a 64 year old patient with normal renal function who is experiencing fluid accumulation in her legs and is showing signs of JVD. Her current total daily dose of furosemide is at the maximum recommended dose. Which of the following is not an appropriate therapeutic change to overcome her diuretic resistance? A. Increase the dose of furosemide, there is no maximum dose when a patient is experiencing fluid overload B. Change from oral furosemide to intravenous C. Fluid and sodium restriction added on to the current dose D. Combine with a thiazide diuretic
What is A: Increase the dose of furosemide, there is no maximum dose when a patient is experiencing fluid overload
400
A patient who has progressed from having an ejection fraction of 25% to 43% is considered to have this type of clinically distinct heart failure.
What is HFpEF, improved
400
This drug-induced adverse reaction accounts for 20-40% of emergency department visits annually, is characterized by an asymmetric nonpitting, nontender buildup of fluid in the interstitial space, can lead to severe hypoxia, is often confused with a true allergy.
What is Angioedema
400
According to the newest guidelines, “In patients with chronic symptomatic HFrEF NYHA class II or III who tolerate an ACE inhibitor or ARB, this is recommended as a replacement to further reduce morbidity and mortality.”
What is Entresto
500
Due to the risk of myocardial damage (and thus development of heart failure) with this medication (range of 1% to 20%),we monitor cumulative lifetime doses and left ventricular ejection fraction before, regularly during, and after treatment.
What is doxorubicin
500
This medication used to enhance cardiac performance for congestive heart failure increases cardiac contractility by acting as an inotrope, decreases afterload by causing vasodilation, and may cause hypokalemia putting patients at an increased risk for ventricular and supraventricular arrythmias
What is milrinone
500
This is the amount of blood pumped out of the ventricle divided by the total amount of blood in the ventricle.
What is the ejection fraction (%)
500
Patients with end stage heart failure often require extra support to maintain their life while waiting for a heart transplant. One option is to facilitate the movement of blood into the aorta which reduces stress on the weakened ventricle, allowing patients to be discharged from the hospital and have an acceptable quality of life while waiting for a donor heart to become available.
What is a LVAD
500
If a heart failure patients is taking an angiotensin converting enzyme inhibitor (ACEI), an aldosterone antagonist, a diuretic, and a beta blocker, and is having symptoms of heart failure but is hemodynamically stable, a greater reduction in morbidity would results by increasing the dose of this medication.
What is the beta blocker
M
e
n
u