Knowledge Check: Pathophysiology of Heart Failure
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Question 1 of 10
1. Question
Which of the following is a sign of “increased preload” in a 10 year old boy with heart failure?
Hint
Hint: Chapter 1, 01:45. The heart is a pump. Increased preload refers to increased fluid in the heart. If the pump does not function well, the fluid will back-up into other organs.
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Question 2 of 10
2. Question
In which of the following types of cardiomyopathy are the ventricles not able to relax properly during diastole?
Hint
Hint: Chapter 1, 3:30. In this type of cardiomyopathy, the systolic function (the pumping of the heart) is preserved. Because the ventricles cannot relax, the blood backs-up into the atria and then either into the lungs or systemic circulation based on which side of the heart is affected (left versus right).
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Question 3 of 10
3. Question
Which of the following equations related to cardiac output is correct?
Hint
Hint: Chapter 1, 07:00. Cardiac Output refers the volume of blood that is pumped by the heart in one minute.
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Question 4 of 10
4. Question
Which of the following can be seen in a patient with ventricular dysfunction?
Hint
Hint: Chapter 1, 07:00. In ventricular dysfunction, the heart cannot squeeze properly, so its contractility and therefore the stroke volume are impaired. The heart tries to maintain its cardiac output by adjusting how fast it beats.
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Question 5 of 10
5. Question
You are seeing a 10 year- old patient in clinic with a known congenital heart defect. On history, he tells you he feels very comfortable at rest with no difficulty breathing, fatigue, chest pain or palpitations. When he plays soccer, he occasionally has to stop to catch his breath. Given this history what class of heart failure does he have according to the New York Heart Association Heart Failure classification system?
Hint
Hint: Chapter 2, 00:18. He is asymptomatic at rest, but has some limitations in physical activity.
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Question 6 of 10
6. Question
A 15 month-old girl with a known congenital heart defect presents with tachypnea and shortness of breath at rest. Her mother comments her tachypnea and shortness of breath is worse when eating or walking. Her weight-for-age has dropped to the 2nd percentile on her growth curve. Using the Ross Classification for Heart Failure, what class heart failure does she have?
Hint
Hint: Chapter 2, 01:23. This patient is symptomatic at rest and with exertion and is having failure to thrive.
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Question 7 of 10
7. Question
Which of the following best describes a patient who would be classified as having Stage A heart failure?
Hint
Hint: Chapter 2, 03:04; Stage A patients have an underlying risk of heart disease but does not have any symptoms of heart failure and has normal cardiac function.
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Question 8 of 10
8. Question
You see a patient with a history of dilated cardiomyopathy. The history, physical exam and echocardiogram confirm that he has Stage A heart failure. What intervention should you propose to the family?
Hint
Hint: Chapter 2, 04:28. Stage A heart failure is the least severe and these patients do not have any signs or symptoms of heart failure
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Question 9 of 10
9. Question
You are seeing a 6 year old previously healthy boy presenting with difficulty breathing and worsening cough of 2 weeks duration. He reports fatigue and diffuse abdominal discomfort. On physical exam, he is afebrile with an audible dry cough. Lung exam reveals diffuse crackles and end-expiratory wheezes at the lung bases bilaterally. What should you do next to further evaluate the cause of symptoms in this patient?
Hint
Hint: Chapter 3, 00:51. In young children, heart failure can be mistaken for asthma, viral syndrome, gastroentritis. The next step in your management should be to assess for cardiomegaly and evidence of pulmonary edema.
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Question 10 of 10
10. Question
You are evaluating a patient with end-stage heart failure for possible heart transplantation. Which of the following do you expect to see on his blood tests?
Hint
Hint: Chapter 4, 00:46. Patients with severe heart failure and chronic low cardiac output have evidence of end-organ hypoperfusion and evidence of compensatory mechanisms to increase oxygen delivery.
