2018 Board Review Pre-Test:
HF and Biomarkers

HF and Biomarkers - Michael Felker, MD, FHFSA

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

Question Title

* 1. The primary trigger for release of BNP from the myocardium is:

A. Volume overload

B. Myocardial wall stress

C. Renal dysfunction

D. Myocardial ischemia

Question Title

* 2. 75-year-old man with non-ischemic CM is admitted to outside hospital. BNP on admission is 500 pg/mL. He is transferred immediately to your institution for further management. NT-proBNP at your hospital the following day is 2900 pg/mL.

Which of the following is true?

A. His clinical condition has worsened since his initial presentation

B. The BNP and NT-proBNP values are approximately equivalent

C. Natriuretic peptide levels are not useful in the elderly

D. He must have received nesiritide since his initial presentation

Question Title

* 3. A 58-year-old woman comes to the emergency department complaining of 3 days of gradual onset dyspnea. She has a history of obesity, HTN and diabetes but no prior history of heart failure. Exam shows body mass index of 43, blood pressure of 130/78, JVP difficult to assess, clear lungs, distant heart sounds, 1 + lower extremity edema. A NT-proBNP drawn in the emergency department is 79 pg/mL.

What is the best interpretation of the value?

A. Proves that this patient has heart failure

B. Proves that patient does not have heart failure

C. NPs are not useful in patients with diabetes

D. NT-proBNP is likely falsely low due to obesity

Question Title

* 4. A 58-year-old man with history of DCM is hospitalized with 2 weeks of progressive edema and worsening dyspnea on exertion. Patient denies chest pain. On admission, serum creatinine is 1.7 mg/dL and hs troponin T is 21 ng/l 99%URL for local lab = 14 ng/l) ECG shows lateral t wave flattening.

Which of the following is most likely to be true?

A. The diagnosis of DCM is incorrect

B. The cause of the HF decompensation is likely a coronary embolus causing an MI

C. The troponin elevation is due to Acute HF

D. The troponin elevation is of no consequence

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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