Knowledge Check: Management of Congestive Heart Failure
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Question 1 of 10
1. Question
A 5 year old boy with known heart failure presents to the emergency room with shortness of breath. His vital signs are within normal limits. On exam, he is warm and well perfused, but has ascites and peripheral edema. His chest radiograph shows diffuse pulmonary edema. Which of the following therapies is indicated at this time?
Hint
This patient exhibits signs of congestion and fluid overload. The next appropriate therapy is removing some of the excess fluid. See 3:36 in the video.
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Question 2 of 10
2. Question
How do diuretics (e.g. furosemide) help in the treatment of heart failure?
Hint
Diuretics work on relieving volume overload symptoms. See 7:27 in the video.
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Question 3 of 10
3. Question
How does digoxin help in the treatment of heart failure?
Hint
Digoxin increases intracellular calcium, which is the main cation involved in myocardial contractility. See 8:38 in the video.
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Question 4 of 10
4. Question
How do ACE inhibitors (e.g. captopril) help in the treatment of heart failure?
Hint
The sympathetic tone leads to tachycardia, fluid retention and hypertension. ACE inhibitors inhibit angiotensin II. See 9:30 in the video.
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Question 5 of 10
5. Question
Which of the following is a potential side effect of beta blockers (e.g. carvedilol) when used in the treatment of heart failure?
Hint
Beta blockers counteract the chronic sympathetic system activation. See 11:19 in the video.
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Question 6 of 10
6. Question
How do pulmonary vasodilators (e.g. sildenafil) help in the treatment of heart failure?
Hint
Pulmonary vasodilators help with right-sided heart failure by targeting elevated pulmonary vascular resistance. See 12:04 in the video.
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Question 7 of 10
7. Question
How does milrinone help in the treatment of decompensated heart failure?
Hint
Milrinone is a phophodiesterase-3 inhibitor, which relaxes the smooth muscles of blood vessels. See 12:53 in the video.
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Question 8 of 10
8. Question
What should the total fluid intake in infants (weight < 10kg) with heart failure be limited to?
Hint
Fluid restriction is an important aspect of heart failure management and can decrease the amount of diuretics needed. In children 10-30 kg, the recommended fluid intake is 600 mL-1 liter, whereas in older children and young adults the limit is 1-2 liters/day. See 15:15 in the video.
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Question 9 of 10
9. Question
In a patient with severe left ventricular dysfunction (i.e. ejection fraction <30%), what additional medication should be added in addition to his/her heart failure medication regimen?
Hint
Anticoagulation is an important aspect of heart failure management. For moderate left ventricular dysfunction, an anti-platelet medication such as aspirin should be started. See 16:36 in the video.
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Question 10 of 10
10. Question
Which of the following pairings of heart failure staging and treatment is correct?
Hint
Stage A is the least severe, while stage D is the most severe. See 18:23 in the video.