LearnWithTest

1 A 64-year-old man with known ischemic cardiomyopathy presents with worsening dyspnea, orthopnea, and bilateral basal crepitations. Echocardiography shows LVEF 28%. Which drug provides the greatest mortality benefit in this patient?

Furosemide ACE inhibitor Digoxin Short-acting nitrates

2 A 70-year-old hypertensive woman presents with exertional dyspnea. Echocardiography shows concentric LV hypertrophy with preserved ejection fraction of 60%. What is the most likely diagnosis?

HFrEF HFpEF Dilated cardiomyopathy Acute heart failure

3 A patient with chronic heart failure develops sudden weight gain of 3 kg over 4 days, ankle edema, and raised JVP. What is the primary mechanism responsible?

Reduced parasympathetic tone Activation of RAAS causing sodium and water retention Increased myocardial oxygen demand Coronary artery spasm

4 A patient with stable HFrEF is started on a beta blocker and develops transient worsening of dyspnea in the first week. What is the most likely explanation?

Allergic reaction Negative inotropic effect during initiation Pulmonary embolism Progressive valve disease

5 A patient with acute decompensated heart failure presents with cold extremities, hypotension, oliguria, and pulmonary edema. Which hemodynamic profile best describes this patient?

Warm and dry Warm and wet Cold and dry Cold and wet

6 A patient with CHF has serum potassium of 6.0 mmol/L and rising creatinine. Which drug should be stopped first?

Furosemide Beta blocker Spironolactone SGLT2 inhibitor

7 A patient with CHF and atrial fibrillation remains symptomatic despite optimal therapy. Which drug is most useful for symptom control and ventricular rate control?

Adenosine Digoxin Verapamil Flecainide

8 A patient with heart failure has raised JVP, hepatomegaly, ascites, and pedal edema. Which ventricle is primarily failing?

Left ventricle Right ventricle Left atrium Interventricular septum

9 A patient with suspected heart failure has normal BNP levels. What is the most appropriate interpretation?

Severe heart failure is present Heart failure is unlikely Isolated right-sided heart failure Valvular heart disease

10 A patient with HFrEF is switched from enalapril to sacubitril–valsartan. What precaution is mandatory?

Increase loop diuretic dose 36-hour washout period Add digoxin Monitor INR

11 A patient with CHF has an S3 gallop on auscultation. What does this finding indicate?

Pericardial constriction Volume overload Valvular stenosis Isolated diastolic dysfunction

12 A patient with chronic heart failure and LVEF 30% remains symptomatic despite optimal therapy. Which device reduces sudden cardiac death risk?

Cardiac resynchronization therapy Implantable cardioverter defibrillator Permanent pacemaker Intra-aortic balloon pump

13 A patient with CHF develops worsening renal function after aggressive diuretic therapy. What is this condition called?

Hepatorenal syndrome Cardiorenal syndrome Acute tubular necrosis Contrast-induced nephropathy

14 A patient with HFpEF presents with exertional dyspnea. Which management strategy is most important?

Routine inotropes Blood pressure and comorbidity control High-dose digoxin Chronic nitrates

15 A patient with end-stage congestive heart failure remains symptomatic despite maximal medical therapy. What is the most definitive treatment option?

High-dose diuretics Long-term digoxin Left ventricular assist device or heart transplantation Oral nitrates