Background/Risk Factors
a. Obesity
b. Renal failure
c. Diabetes Mellitus
d. Bacterial Sepsis
B & D
renal failure and bacterial sepsis
Which beta blocker CAN be used in HF?
a. Metoprolol tartrate
b. Nadolol
c. Metoprolol succinate
d. propranolol
C. Metoprolol succinate
In what patient population can hydralazine/nitrates be beneficial in?
African American
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
55 - 70%
Preferred class of diuretics for those with HF
Loop diuretics
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
Target serum level for digoxin is what?
0.5 to < 0.9 ng/mL
What are classification system is focused on symptoms?
NYHA Functional Class
How do you switch a patient from an ACE inhibitor to an ARNI?
36 hour washout
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?
Which agent requires a pregnancy test prior to initiation?
a. ivabradine
b. digoxin
c. vericiguat
d. lisinopril
c. vericiguat
What is NOT a common cause of HF?
a. MI
b. HTN
c. Chronic methamphetamine use
d. Valvular Heart Disease
C. chronic methamphetamine use
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
True or False:
Digoxin can be used in patients with symptomatic HFrEF despite GDMT to reduce mortality
FALSE
reduces hospitalizations
Signs and symptoms of digoxin toxicity include all the following EXCEPT:
a. Vomiting
b. Hypoglycemia
c. Vision changes
d. Cardiac arrhythmias
B. hypoglycemia
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
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
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
What must be performed two weeks after starting ivabradine?
EKG