2018 Board Review Pre-Test:
Drug Therapy for Chronic Heart Failure II

Drug Therapy for Chronic Heart Failure II - Mark Drazner, MD, FHFSA

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

Question Title

* 1. In which of the following patients with HFrEF would it be most appropriate to use the fixed dose combination of Isosorbide dinitrate/hydralazine?

A. White man, class 3, tolerating ACEi and BBL

B. White woman, class 2, newly diagnosed not yet on an rx

C. AA man, class 3, newly diagnosed not yet on any rx

D. AA woman, class 2, tolerating ACEi and BBL

E. AA man, class 3, tolerating ACEi and BBL

Question Title

* 2. 40-year-old man with nonischemic cardiomyopathy and symptomatic heart failure for 10 years has been on ACEi, BBL, furosemide, and digoxin. His sister is beginning her third year of medical school and contacts you to discuss his use of digoxin.

Which of the following is true?

A. It will reduce his mortality

B. It will have no impact on his risk of heart failure hospitalization

C. Withdrawal may precipitate decompensation

D. Dosing is irrespective of renal function

E. Maintaining a trough level > 1 ng/mL is optimal

Question Title

* 3. 55-year-old man with nonischemic cardiomyopathy and NYHA class 3 HF has LVEF 25%. There is no LV thrombus on echocardiogram. He has no known atherosclerotic disease and he is not diabetic but has hypertension. He has paroxysmal atrial fibrillation. Which of the following is true regarding use of antiplatelet/anticoagulation in him?

A. Aspirin will improve his survival

B. Coumadin is indicated

C. A cardiac MRI should be obtained and coumadin started only if LV thrombus is seen

D. NOACs should be avoided given his heart failure

E. Coumadin is indicated only if he also has a history of prior stroke

Question Title

* 4. 55-year-old man who is an executive with a 2-year history of nonischemic cardiomyopathy has an ICD in place. He continues to have NYHA class 3 dyspnea. He was in the hospital for a knee arthroscopy and telemetry showed several episodes of NSVT up to 6 beats. He is on maximum ACEi, BBL, and spironolactone. He is in your office and asks if there is ANY other medication he could take to improve his outcome.

You advise he start:

A. Statin

B. Testosterone supplementation

C. Sotalol

D. Coenzyme Q10

E. Omega 3 PUFA

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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