Left-Side Heart Failure
This common symptom occurs due to pulmonary congestion.
What is dyspnea (shortness of breath)?
Rationale: Left-sided failure causes fluid backup into the lungs, impairing gas exchange.
Distension of this neck vein is a classic sign of right-sided heart failure.
What is jugular vein distension (JVD)?
Rationale: Venous blood backs up into systemic circulation.
Cardiomegaly is most often detected with this imaging test.
What is a chest X-ray?
Rationale: An enlarged heart silhouette can be seen on chest radiographs.
Normal saline (0.9% NaCl) is classified as this type of fluid.
What is isotonic?
Rationale: Its osmolarity is similar to plasma, preventing fluid shifts.
Low potassium is known as this condition.
What is hypokalemia?
Rationale: Serum K+ < 3.5 mmol/L.
This nighttime symptom forces patients to wake up suddenly gasping for air.
What is paroxysmal nocturnal dyspnea?
Rationale: Pulmonary fluid accumulation worsens when lying down.
A patient with right-sided heart failure will often have swelling in these body parts.
What are the ankles, legs, or feet (peripheral edema)?
Rationale: Systemic venous congestion causes fluid retention in dependent areas.
Hypertension can lead to this type of cardiac hypertrophy.
What is left ventricular hypertrophy?
Rationale: Chronic high afterload causes muscle thickening.
This type of fluid shifts water into cells, useful in hypernatremia.
What is hypotonic solution (e.g., 0.45% NaCl)?
Rationale: Hypotonic solutions draw water into cells.
Hyperkalemia often shows this change on ECG.
What are peaked T waves?
Rationale: High potassium alters cardiac conduction.
Patients with left-sided heart failure often sleep propped up on pillows due to this symptom.
What is orthopnea?
Rationale: Lying flat worsens pulmonary congestion, making breathing difficult.
Right-sided heart failure can cause this complication involving the liver.
What is hepatomegaly (or congestive hepatopathy)?
Rationale: Venous congestion enlarges and impairs the liver.
Dilated cardiomyopathy often results in cardiomegaly due to this mechanism.
What is ventricular dilation and impaired contractility?
Rationale: Chambers enlarge as muscle weakens.
Hypotonic IV fluids, such as 0.45% NaCl, risk causing this complication.
What is cerebral edema?
Rationale: Water moves into cells, increasing intracranial pressure.
Hyponatremia can cause this dangerous neurological complication.
What is cerebral edema/seizures?
Rationale: Low sodium causes fluid to shift into brain cells.
Crackles on lung auscultation are due to this pathophysiological process.
What is fluid accumulation in alveoli?
Rationale: Pulmonary edema causes crackles on auscultation.
Chronic right-sided heart failure can lead to this abdominal complication.
What is ascites?
Rationale: Increased hydrostatic pressure in the hepatic veins and portal system leads to fluid leakage.
Cardiomegaly can lead to this life-threatening electrical complication.
Answer: What is arrhythmia?
Rationale: Enlarged chambers disrupt conduction pathways.
Colloid IV solutions, like albumin, expand plasma volume through this mechanism.
What is increasing oncotic pressure?
Rationale: They pull water into the intravascular space
Hypocalcemia can cause this classic neuromuscular sign.
What is Chvostek’s sign or Trousseau’s sign?
Rationale: Hypocalcemia increases neuromuscular excitability.
The most common cause of left-sided heart failure is this condition.
What is hypertension?
Rationale: High afterload makes the left ventricle hypertrophy and eventually fail.
Hepatomegaly occurs due to congestion in this vessel system.
What is the portal venous system?
Rationale: Backup increases pressure in liver circulation, causing enlargement.
Echocardiography helps assess this functional consequence of cardiomegaly.
What is reduced ejection fraction?
Rationale: Echo shows wall motion abnormalities and systolic dysfunction.
This IV fluid is used for rapid volume replacement in shock.
What is lactated Ringer’s (or normal saline)?
Rationale: Both are isotonic and expand intravascular volume.
This main symptom of hypernatremia results from brain cell dehydration caused by water moving out of cells.
What is altered mental status (confusion, irritability, or seizures)?
Rationale:
Hypernatremia (serum sodium >145 mEq/L) creates a hyperosmolar state, drawing water out of brain cells. This cellular dehydration causes neurological symptoms ranging from mild confusion to seizures and coma.