Font size
S
M
L
XL
WorksheetsCardio Exam 2 - Heart Failure
Total questions: 70
Worksheet time: 35mins
Name
Class
Date
1.
Which side of the heart receives oxygen-poor blood from the body and pumps to the lungs
a)
right
b)
left
2.
At what age does gender become less of a factor when breaking down who gets heart failure
a)
35+
b)
45+
c)
55+
d)
65+
e)
75+
3.
What are the 3 primary symptoms of heart failure
a)
shortness of breath
b)
chronic coughing or wheezing
c)
build-up of fluid
d)
fatigue or lightheaded
e)
nausea or lack of appetite
4.
What are some causes of HF
a)
CAD, HTN
b)
idiopathic cardiomyopathy
c)
toxins, infections<br />
d)
valvular disease
e)
persisent arrhythmias
5.
What are some classifications of HF
a)
acute
b)
chronic
c)
left sided
d)
right sided
6.
Which type of heart failure usually occurs within minutes - days and may be life threatening because the heart cannot compensate quickly enough
a)
acute
b)
chronic
7.
Which type of acute heart failure is more common
a)
ischemic
b)
non-ischemic
8.
Systolic heart failure means there is a decreased
a)
contraction
b)
relaxation
c)
ejection
d)
filling
9.
Diastolic heart failure means there is a decreased
a)
contraction
b)
relaxation
c)
ejection
d)
filling
10.
Left sided heart failure is not effectively pumping blood to the
a)
body
b)
lungs
11.
What is the result in left sided heart failure
a)
increased pressure in pulmonary circulation
b)
increased retention in systemic circulation
c)
pulmonary edema
d)
dyspnea
e)
lower extremity edema
12.
If a patient states that lying down feels like they are being suffocated, which type of heart failure would that lead you to investigate
a)
left side
b)
right side
13.
What are some characteristics of systolic heart failure
a)
left ventricle has a diminished ability to contract
b)
unable to generate necessary force to push enough blood into circulation
c)
end diastolic volume is larger than for healthy heart
d)
enlarged left ventricle
e)
right ventricle has diminished ability to contract
14.
The enjection fraction during systolic heart failure is generally<br />
a)
<45%
b)
<20%
c)
<50%
d)
<65%
15.
What are some causes of systolic heart failure
a)
damage to the myocardium
b)
MI
c)
alcoholism/drugs
d)
lack of exercise
16.
What is the most common cause of coronary artery disease (CAD)
a)
systolic heart failure
b)
diastolic heart failure
c)
hypertension
d)
valvular disease
e)
persisent arrhythmias
17.
What is the most common cause of hypertension
a)
systolic heart failure
b)
diastolic heart failure
c)
valvular disease
d)
persistent arrhythmias
18.
What are some characteristics of diastolic heart failure
a)
left ventricle has a diminished ability to contract
b)
left ventricle has a diminished ability to relax
c)
muscle has become stiff, hypertrophy of ventricle
d)
inadequate filling between heartbeats
e)
right ventricle has diminished ability to contract
19.
What symptoms may present with diastolic heart failure
a)
minimal symptoms at rest
b)
rapid onset of tachycardia with stimuli
c)
typically normal ejection fraction
d)
dyspnea
e)
lower extremity edema
20.
What is the most common cause of right sided heart failure
a)
systolic heart failure
b)
diastolic heart failure
c)
pulmonary arterial HTN
d)
right-side MI
e)
persisent arrhythmias
21.
What are some symptoms of right sided heart failure
a)
increased retention in systemic ciruclation
b)
lower extremity edema
c)
jugular venous distention (JVD)
d)
abdomen fills with fluid (ascites)
e)
occurs subsequently to left sided heart failure
22.
In heart failure, CO decreases. What happens to the MAP
a)
increase
b)
decrease
c)
no change
23.
MAP =
a)
CO x peripheral resistance
b)
CO + peripheral resistance
c)
CO/peripheral resistance
d)
peripheral resistance/CO
24.
How does the sympathetic nervous system affect CO and peripheral resistance<br />
a)
increase CO
b)
decrease CO
c)
increase peripheral resistance
d)
decrease peripheral resistance
25.
What are some examples of neurohormonal activation
a)
sympathetic nervous system
b)
renin-angiotensin-aldosterone system
c)
vasopressin
26.
Prolonged activation of RAAS and AT I receptors leads to
a)
ventricular remodeling
b)
atrial remodeling
c)
arterial remodeling
d)
venous remodeling
27.
What happens to vasopressin when there is a decrease in systemic blood pressure
a)
increases
b)
decreases
c)
remains unchanged
28.
When there is a decrease in cardiac output, what does the sympathetic nervous system effect in order to try and maintain blood pressure
a)
contractility
b)
heart rate
c)
vasoconstriction
d)
circulating volume
29.
When there is a decrease in cardiac output, what does the renin-angiotensin system effect in order to try and maintain blood pressure
a)
contractility
b)
heart rate
c)
vasoconstriction
d)
circulating volume
30.
When there is a decrease in cardiac output, what does the antidiuretic hormone (vasopressin) effect in order to try and maintain blood pressure
a)
contractility
b)
heart rate
c)
vasoconstriction
d)
circulating volume
31.
When the cardiac output decreases and the renin-angiotensin system and/or antidiuretic hormone causes vasoconstriction or increase the circulating volume of blood within the body, what side effects could the venous return to the heart cause
a)
peripheral edema
b)
pulmonary congestion
c)
dyspnea
d)
venous remodeling
32.
What does ventricular remodeling affect
a)
shape
b)
mass
c)
composition
d)
volume of heart
33.
Initially, ventricular remodeling is beneficial because
a)
increased volume increases stroke volume
b)
increased wall thickness initially reduces wall stress and improves contractility
c)
increased hypertrophy/dilation increases wall stress
d)
fibrosis of damaged myocardium impairs contractility
34.
Over time, ventricular remodeling is detrimental because
a)
increased volume increases stroke volume
b)
increased wall thickness initially reduces wall stress and improves contractility
c)
increased hypertrophy/dilation increases wall stress
d)
fibrosis of damaged myocardium impairs contractility
35.
What are the principles in picking a heart failure medication
a)
remove precipitating cause
b)
correct underlying cause
c)
control of congestive heart failure symptoms
d)
cure heart failure
36.
What are some considerations to take in when picking a heart failure medication
a)
reduce workload (preload and afterload)
b)
reduce (control) sodium and water retention
c)
increase myocardial contractility
d)
reduce ventricular remodeling
37.
ACEIs and ARBs work to
a)
decrease vasoconstriction
b)
decrease preload and afterload
c)
increase LV stroke volume
d)
increase vasoconstriction
e)
increase preload and afterload
38.
What are some ADRs of ACEIs and ARBs
a)
hypotension
b)
hyperkalemia
c)
cough (ACEIs), renal insufficiency
d)
angioedema
e)
pregnancy category D
39.
Due to decreased HR, beta blockers
a)
increase CO
b)
decrease CO
c)
does not change CO
40.
What are some benefits that beta blockers provide due to SNS inhibition
a)
reduced vasoconstriction
b)
prevention of cardiac remodeling
c)
reduced myocardial O2 consumption
d)
inhibition of renin release
e)
increase preload and afterload
41.
What are some examples of beta-blocker drugs
a)
carvedilol
b)
bisoprolol
c)
metoprolol succinate
d)
lisinopril
e)
benazepril
42.
What are some ADRs of beta blocker drugs
a)
bradycardia, cold extremities
b)
bronchoconstriction
c)
deterioration (acute HF)
d)
hypoglycemia
e)
insomnia, abnormal dreams
43.
How do diuretics help patients with HR<br />
a)
decrease preload (diuresis)
b)
decrease venous pressure
c)
decrease Na/H2O retention
d)
reduce cardiac size and improve pump efficiency
e)
improve volume overload and congestive symptoms
44.
How does aldosterone affect those with HF<br />
a)
increase Na and H2O retention
b)
increase vasoconstriction
c)
upregulation of inflammatory mediators
d)
collagen synthesis
e)
increase platelet activation and aggregation
45.
How does spironolactone help patients with HF
a)
aldosterone antagonists
b)
significant antimineralocorticoid activity (inhibit Na and H2O reabosrption, increases K reabsorption)
c)
moderate antiandrogenic activity
d)
prodrug
e)
no antiandrogenic activity
46.
What are some ADRs of Spironolactone
a)
hyperkalemia
b)
gynecomastia (dose-dependent)
c)
menstrual disturbances
d)
hypoglycemia
e)
hypokalemia
47.
How to vasodilators benefit patients with HF
a)
decrease preload
b)
decrease afterload
c)
may reduce ventricular modeling
d)
increase preload
e)
increase afterload
48.
Which vasodilator combination achieves all of the benefits vasodilators can have on patients with HF
a)
hydralazine
b)
isosorbide dinitrate
c)
nitroglycerin
d)
nitro-bid
49.
What are some ADRs for hydralazine
a)
lupus-like syndrome
b)
headache
c)
tachycardia<br />
d)
flushing
e)
bradycardia
50.
How do inotropes help patients with HF<br />
a)
increase CO
b)
decrease CO
c)
decrease Na/H2O retention
d)
decrease peripheral resistance
51.
Although inotropes increase contractility of the heart, it also
a)
increases O2 demand
b)
increases risk of arrhythmias
c)
may increase mortality
d)
decreases O2 demand
e)
increases afterload
52.
Milrinone is an agent that is used for
a)
intractable heart failure
b)
right side heart failure
c)
left side heart failure
53.
Milrinone is a phosphodiesterase-3 inhibitor that
a)
prevents degradation of cAMP
b)
increases activation of PKA
c)
increases intracellular Ca2+ and contractility
d)
decreases intracellular Ca2+ and contractility
e)
decreases activation of PKA
54.
What are some ADRs of Milrinone
a)
arrhythmias
b)
hypotension
c)
headache
d)
GI upset
e)
bradycardia
55.
What are some characteristics of digoxin
a)
cardiac glycoside
b)
increased force of contraction, decreased HR
c)
narrow therapeutic index drug
d)
inhibits Na/K ATPase in cardiac muscle
e)
increased vagal nerve activity (parasympathetic)
56.
What are some (usually dose dependent) ADRs of Digoxin
a)
GI Upset
b)
vision disturbances
c)
arrhythmias
d)
electrolyte abnormalities
e)
flushing
57.
Entresto is a combination drug of
a)
hydralazine
b)
isosorbide dinitrate
c)
sacubitril
d)
valsartan
58.
What does Sacubitril (Entresto) inhibit
a)
neprilysin
b)
angiotensin
c)
cAMP
d)
aldosterone
59.
What medications should be avoided in HF
a)
NSAIDs
b)
Non-DHP calcium channel blockers
c)
most antiarrhythmics
d)
acetaminophen
60.
Why should NSAIDs be avoided in HF
a)
prevent vasodilation of afferent arteriole
b)
increase fluid retention
c)
worsen heart failure
d)
allow vasodilation of afferent arteriole
e)
decrease fluid retention
61.
Why should Non-DHP calcium channel blockers be avoided in HF
a)
prevent vasodilation of afferent arteriole
b)
increase fluid retention
c)
worsen heart failure
d)
allow vasodilation of afferent arteriole
e)
decrease fluid retention
62.
What exceptions of antiarrhythmics are allowed for those with HF
a)
some beta blockers
b)
amiodarone
c)
dofetilide
d)
sodium channel blockers
e)
potassium channel blockers
63.
If EF is 55% and stroke volume is 100 mL, what is the end-diastolic volume
a)
159 mL
b)
45 mL
c)
55 mL
d)
182 mL
64.
A patient with pulmonary hypertension experiences jugular distension and swelling of feet. Which form of heart failure is this most likely associated with?
a)
left sided
b)
right sided
c)
systolic
d)
diastolic
65.
The activity of carvedilol on alpha receptors will produce which of the following effects<br />
a)
increase peripheral resistance
b)
increased preload
c)
decrease heart rate
d)
decrease afterload
66.
Because digoxin binds the same site on ATPase as potassium, hypokalemia will
a)
increase toxicity of digoxin in overdose
b)
decrease toxicity of digoxin in overdose
c)
not alter toxicity of digoxin in overdose
d)
digoxin causes hypokalemia
67.
Relative to a healthy patient, a patient with diastolic HF will have
a)
increased SV
b)
increased CO
c)
decreased ejection fraction
d)
decreased end-diastolic volume
68.
If a drug increases muscle tension and contraction at high pressure, what would it be used to treat
a)
systolic heart failure
b)
diastolic heart failure
69.
If a drug is a cardiac muscle modulator with relaxant effects, what would it be used to treat
a)
systolic heart failure
b)
diastolic heart failure
70.
If a patient experiences digoxin toxicity, what will that patient have and what can be used to treat it
a)
hypokalemia
b)
hyperkalemia
c)
digibind
d)
aldosterone
Reset
