2018 Board Review Pre-Test:
Acute Decompensated Heart Failure II

Acute Decompensated Heart Failure II - Michael Felker, MD, FHFSA

Please complete this brief Pre-Test to give a baseline for learning.

Question Title

* 1. 61-year-old woman with known HFrEF (EF 25%), DM, CKD. 2 hospitalizations for AHF in past year. Takes coreg, lisinopril, spiro, fursosemide. Comes to clinic with 3 weeks gradually progressive DOE, edema, despite high dose furosemide 120mg PO BID. Exam shows elevated JVP, peripheral edema. Cr 1.6 mg/dL (baseline 1.3 mg/dL).
Which of the following is the best treatment option now?

A. Increase dose of oral furosemide

B. Switch to torsemide

C. Add metolazone

D. Admit for IV diuretics

Question Title

* 2. An 81-year-old woman with a history of hypertension presents to the ED with sudden onset of severe shortness of breath. Blood pressure is 185/110, Heart rate 105, RR =20, oxygen saturation 92%. Physical exam shows rales 2/3 of lung fields bilaterally and chest x-ray shows pulmonary edema. She is given IV furosemide and oxygen in triage.

What is the most appropriate next treatment?

A. Non-invasive ventilation

B. IV nitroglycerin

C. 5mg metoprolol slow IV push

D. IV milrinone infusion

Question Title

* 3. Which of the following is true about the routine use of inotropic agents in acute heart failure?

A. They decrease length of stay

B. They facilitate diuresis

C. They preserve renal function

D. They are not routinely indicated in AHF

Question Title

* 4. Which of the following is most correct regarding the use of beta blockers in patients with acute heart failure?

A. The dose should be halved at the time of hospitalization

B. They should generally be continued in patients on chronic therapy during hospitalization

C. In patients not on therapy it is better to start them prior to hospital discharge than to defer to the outpatient setting

D. B and C

Question Title

* 5. Please provide your first and last name.
Pre-test questions will not be scored, your name is required solely to confirm completion.

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