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Congestive Heart Failure Exam 2

Congestive Heart Failure Exam 2

 

This is a self-grading exam. Answers are entered by clicking the button corresponding to your selection. The examination is scored by clicking 'Grade Test' at the bottom of the form. Correct answers are found through hyperlinks at the bottom of the page.



Question # 1 (Multiple Choice) Most important acute factor in changing the position of the force-velocity and ventricular function curves:

    A) circulating catecholamines -- adrenal medullary release
    B) reduced parasympathetic tone
    C) increased adenosine release
    D) increased cardiac adrenergic nerve activity

Question # 2 (Multiple Choice) Drug used in treating CHF: associated with a reversible thrombocytopenia:

    A) dopamine (Intropin)
    B) hydralazine (Apresoline)
    C) methyldopa (Aldomet)
    D) amrinone (Inocor)
    E) digoxin (Lanoxin, Lanoxicaps)

Question # 3 (Multiple Answer) First-line agents used in treating congestive heart failure:

    A) hydralazine (Apresoline)
    B) dobutamine (Dobutrex)
    C) ACE inhibitors
    D) thiazide diuretics
    E) calcium channel blockers

Question # 4 (Multiple Choice) Left ventricular stroke volume: relationship to afterload

    A) direct
    B) inverse

Question # 5 (Multiple Choice) Most important digitalis-mediated cardiac effect:

    A) tachycardia
    B) improved real perfusion
    C) decreased AV transmission
    D) shift of the force-velocity relationship upward

Question # 6 (Multiple Answer) Short-term inotropic support of the failing myocardium:

    A) furosemide (Lasix)
    B) diltiazem (Cardiazem)
    C) dobutamine (Dobutrex)
    D) milrinone (Primacor)
    E) dopamine (Intropin)

Question # 7 (Multiple Answer) Exogenous agents that improve ventricular performance,

    A) isoproterenol (Isuprel)
    B) theophylline
    C) diltiazem (Cardiazem)
    D) nifedipine (Procardia, Adalat)
    E) caffeine

Question # 8 (Multiple Answer) Appropriate interventions in the management of cardiogenic shock:

    A) supplemental oxygen
    B) surgery to repair valve pathologies or to revascularize
    C) intra-aortic balloon pump
    D) IV nitroglycerin

Question # 9 (Multiple Choice) Perhaps more useful in a CHF patient with marginal GFR due to poor renal perfusion:

    A) dopamine (Intropin)
    B) dobutamine (Dobutrex)
    C) methoxamine (Vasoxyl)

Question # 10 (Multiple Choice) Less arrhythmogenic; less tachycardia

    A) dopamine (Intropin)
    B) dobutamine (Dobutrex)

Question # 11 (Multiple Answer) Drugs used in the management of congestive heart failure:

    A) torsemide (Demadex)
    B) dobutamine (Dobutrex)
    C) milrinone (Primacor)
    D) ramipril (Altace)
    E) digoxin (Lanoxin, Lanoxicaps)

Question # 12 (Multiple Choice) Vasoconstrictors:

    A) endothelin I
    B) angiotensin II
    C) both
    D) neither

Question # 13 (Multiple Choice) Mechanism by which vasodilators improve myocardial performance in CHF:

    A) increase heart rate
    B) promote diuresis
    C) reduce afterload
    D) reduce pulmonary blood flow

Question # 14 (Multiple Answer) Physiological effects associated with acute pulmonary edema:

    A) elevation of pulmonary capillary pressures
    B) alveolar edema
    C) rales
    D) expectoration of blood-tinged fluid
    E) pretibial edema

Question # 15 (Multiple Choice) Agent of choice among phosphodiesterase inhibitors for short-term parenteral support in severe heart failure patients:

    A) dopamine (Intropin)
    B) milrinone (Primacor)
    C) dobutamine (Dobutrex)
    D) IV isoproterenol (Isuprel)
    E) IV epinephrine

Question # 16 (Multiple Answer) Agents which depress ventricular performance:

    A) dopamine (Intropin)
    B) general anesthetics
    C) disopyramide (Norpace)
    D) procainamide (Procan SR, Pronestyl-SR)

Question # 17 (Multiple Choice) Inhibitors and Na/K ATPase: used in management of CHF:

    A) enalapril (Vasotec)
    B) amrinone (Inocor)
    C) dobutamine (Dobutrex)
    D) digoxin (Lanoxin, Lanoxicaps)
    E) minoxidil (Loniten)

Question # 18 (Multiple Choice) Effective exercise on intrathoracic blood volume:

    A) increased
    B) decreased
    C) no effect

Question # 19 (Multiple Choice) State of neurohumoral activation in CHF:

    A) highly activated
    B) generally suppressed

Question # 20 (Multiple Choice) Primarily excreted in the urine; digitalis glycosides with half-life of 1.6 days:

    A) digoxin (Lanoxin, Lanoxicaps)
    B) digitoxin
    C) both
    D) neither

Question # 21 (Multiple Choice) Most significant factor in blood flow resistance

    A) vessel length
    B) blood viscosity
    C) vessel radius

Question # 22 (Multiple Choice) Consequences of renin-angiotensin system activation:

    A) reduced circulating angiotensin II
    B) reduced aldosterone
    C) reduced vasoconstriction
    D) none of the above

Question # 23 (Multiple Answer) Physiological depressants of left ventricular function (depression of myocardial force-velocity curves)

    A) hypercapnea
    B) hypoxia
    C) ischemia
    D) acidosis
    E) increased adrenal medullary epinephrine

Question # 24 (Multiple Choice) Clinical efficacy of digitalis glycosides is based on --

    A) decreased transmission through the AV node
    B) increased myocardial contractility
    C) both
    D) neither

Question # 25 (Multiple Answer) Tissue perfusion dependencies:

    A) cardiac
    B) vascular
    C) microcirculatory
    D) humoral

Question # 26 (Multiple Answer) Factors that can cause congestive heart failure:

    A) systemic hypertension
    B) arrhythmias
    C) pulmonary emboli
    D) myocardial infarction

Question # 27 (Multiple Answer) Associated with cardiac cachexia:

    A) impairment of intestinal absorption
    B) anorexia
    C) vomiting
    D) hepatomegaly
    E) increased tumor necrosis factor (circulating)

Question # 28 (Multiple Choice) Atrial contraction (atrophic) is more likely to be important in:

    A) the normal ventricle
    B) the hypertrophic ventricle
    C) no difference

Question # 29 (Multiple Choice) Most common symptom of heart failure:

    A) tachycardia
    B) oligouria
    C) splenomegaly
    D) hepatomegaly
    E) dyspnea

Question # 30 (Multiple Choice) Component of digitalis responsible for Na/K ATPase binding --

    A) genin or aglycone moiety
    B) sugar residues
    C) steroid component

Question # 31 (Multiple Choice) Increase respiratory muscle work of breathing in CHF due to:

    A) interstitial pulmonary edema
    B) vessel enlargement
    C) both
    D) neither

Question # 32 (Multiple Choice) Even in low doses does not increase renal blood flow:

    A) dopamine (Intropin))
    B) dobutamine (Dobutrex)

Question # 33 (Multiple Choice) Has vasodilator properties: causes a decrease in afterload as well as positive inotropism:

    A) dopamine (Intropin)
    B) dobutamine (Dobutrex)
    C) phenylephrine (Neo-Synephrine)

Question # 34 (Multiple Choice) Beta-receptor number and congestive heart failure:

    A) increased
    B) decreased
    C) no change

Question # 35 (Multiple Answer) Factors that promote movement of fluid into extravascular spaces:

    A) hypoxic states -- precapillary arteriolar vasodilatation; postcapillary venule vasoconstriction
    B) circulating toxins
    C) reduced intravascular plasma protein

Question # 36 (Multiple Choice) Sudden-onset of severe shortness-of-breath and coughing -- awakening the patient

    A) orthopnea
    B) paroxysmal dyspnea (nocturnal)

Question # 37 (Multiple Choice) Fundamental abnormality and heart failure -- embodied in:

    A) depression of the myocardial force-glossy relationship
    B) abnormality in length-active muscle tension curves
    C) both
    D) neither

Question # 38 (Multiple Answer) Precipitating causes of congestive heart failure:

    A) AV dissociation
    B) severe bradycardia
    C) reduce synchrony of ventricular contraction
    D) tachyarrhythmias

Question # 39 (Multiple Answer) Factors influencing end-diastolic volumes:

    A) volume depletion
    B) body position
    C) venous tone
    D) skeletal muscle activity
    E) uterine contraction

Question # 40 (Multiple Choice) Factor(s) affecting microvascular blood flow:

    A) colloid forces
    B) capillary hydrostatic pressures
    C) both
    D) neither

Question # 41 (Multiple Choice) Bipyridines -- phosphodiesterase inhibitors used in CHF:

    A) dobutamine (Dobutrex)
    B) amrinone (Inocor)
    C) hydralazine (Apresoline)
    D) minoxidil (Loniten)
    E) furosemide (Lasix)

Question # 42 (Multiple Choice) Cardiac output is directly dependent upon:

    A) peripheral vascular resistance
    B) intravascular blood volume
    C) heart rate alone
    D) heart rate and stroke volume
    E) stroke volume and peripheral vascular systems

Correct Answers

1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42






































Question # 1 (Multiple Choice) Most important acute factoring changing the position of the force-velocity and ventricular function curves:

Answer: (D) increased cardiac adrenergic nerve activity

BACK







































Question # 2 (Multiple Choice) Drug used in treating CHF: associated with a reversible thrombocytopenia:

Answer: (D) amrinone (Inocor)

BACK







































Question # 3 (Multiple Answer) First-line agents used in treating congestive heart failure:

(C) ACE inhibitors

(D) thiazide diuretics

BACK







































Question # 4 (Multiple Choice) Left ventricular stroke volume: relationship to afterload

Answer: (B) inverse

BACK







































Question # 5 (Multiple Choice) Most important digitalis-mediated cardiac effect:

Answer: (D) shift of the force-velocity relationship upward

BACK







































Question # 6 (Multiple Answer) Short-term inotropic support of the failing myocardium:

(C) dobutamine (Dobutrex)

(D) milrinone (Primacor)

(E) dopamine (Intropin)

BACK







































Question # 7 (Multiple Answer) Exogenous agents that improve ventricular performance,

(A) isoproterenol (Isuprel)

(B) theophylline

(E) caffeine

BACK







































Question # 8 (Multiple Answer) Appropriate interventions in the management of cardiogenic shock:

(A) supplemental oxygen

(B) surgery to repair valve pathologies or to revascularize

(C) intra-aortic balloon pump

(D) IV nitroglycerin

BACK







































Question # 9 (Multiple Choice) Perhaps more useful in a CHF patient with marginal GFR due to poor renal perfusion:

Answer: (A) dopamine (Intropin)

BACK







































Question # 10 (Multiple Choice) Less arrhythmogenic; less tachycardia

Answer: (B) dobutamine (Dobutrex)

BACK







































Question # 11 (Multiple Answer) Drugs used in the management of congestive heart failure:

(A) torsemide (Demadex)

(B) dobutamine (Dobutrex)

(C) milrinone (Primacor)

(D) ramipril (Altace)

(E) digoxin (Lanoxin, Lanoxicaps)

BACK







































Question # 12 (Multiple Choice) Vasoconstrictors:

Answer: (C) both

BACK







































Question # 13 (Multiple Choice) Mechanism by which vasodilators improve myocardial performance in CHF:

Answer: (C) reduce afterload

BACK







































Question # 14 (Multiple Answer) Physiological effects associated with acute pulmonary edema:

(A) elevation of pulmonary capillary pressures

(B) alveolar edema

(C) rales

(D) expectoration of blood-tinged fluid

BACK







































Question # 15 (Multiple Choice) Agent of choice among phosphodiesterase inhibitors for short-term parenteral support in severe heart failure patients:

Answer: (B) milrinone (Primacor)

BACK







































Question # 16 (Multiple Answer) Agents which depress ventricular performance:

(B) general anesthetics

(C) disopyramide (Norpace)

(D) procainamide (Procan SR, Pronestyl-SR)

BACK







































Question # 17 (Multiple Choice) Inhibitors and Na/K ATPase: used in management of CHF:

Answer: (D) digoxin (Lanoxin, Lanoxicaps)

BACK







































Question # 18 (Multiple Choice) Effective exercise on intrathoracic blood volume:

Answer: (A) increased

venoconstriction BACK







































Question # 19 (Multiple Choice) State of neurohumoral activation in CHF:

Answer: (A) highly activated

BACK







































Question # 20 (Multiple Choice) Primarily excreted in the urine; digitalis glycosides with half-life of 1.6 days:

Answer: (A) digoxin (Lanoxin, Lanoxicaps)

BACK







































Question # 21 (Multiple Choice) Most significant factor in blood flow resistance

Answer: (C) vessel radius

fourth power dependency BACK







































Question # 22 (Multiple Choice) Consequences of renin-angiotensin system activation:

Answer: (D) none of the above

BACK







































Question # 23 (Multiple Answer) Physiological depressants of left ventricular function (depression of myocardial force-velocity curves)

(A) hypercapnea

(B) hypoxia

(C) ischemia

(D) acidosis

BACK







































Question # 24 (Multiple Choice) Clinical efficacy of digitalis glycosides is based on --

Answer: (C) both

BACK







































Question # 25 (Multiple Answer) Tissue perfusion dependencies:

(A) cardiac

(B) vascular

(C) microcirculatory

(D) humoral

BACK







































Question # 26 (Multiple Answer) Factors that can cause congestive heart failure:

(A) systemic hypertension

(B) arrhythmias

(C) pulmonary emboli

(D) myocardial infarction

BACK







































Question # 27 (Multiple Answer) Associated with cardiac cachexia:

(A) impairment of intestinal absorption

(B) anorexia

(C) vomiting

(D) hepatomegaly

(E) increased tumor necrosis factor (circulating)

BACK







































Question # 28 (Multiple Choice) Atrial contraction (atrophic) is more likely to be important in:

Answer: (B) the hypertrophic ventricle

reduced compliance BACK







































Question # 29 (Multiple Choice) Most common symptom of heart failure:

Answer: (E) dyspnea

BACK







































Question # 30 (Multiple Choice) Component of digitalis responsible for Na/K ATPase binding --

Answer: (A) genin or aglycone moiety

BACK







































Question # 31 (Multiple Choice) Increase respiratory muscle work of breathing in CHF due to:

Answer: (C) both

BACK







































Question # 32 (Multiple Choice) Even in low doses does not increase renal blood flow:

Answer: (B) dobutamine (Dobutrex)

BACK







































Question # 33 (Multiple Choice) Has vasodilator properties: causes a decrease in afterload as well as positive inotropism:

Answer: (B) dobutamine (Dobutrex)

BACK







































Question # 34 (Multiple Choice) Beta-receptor number and congestive heart failure:

Answer: (B) decreased

BACK







































Question # 35 (Multiple Answer) Factors that promote movement of fluid into extravascular spaces:

(A) hypoxic states -- precapillary arteriolar vasodilatation; postcapillary venule vasoconstriction

(B) circulating toxins

(C) reduced intravascular plasma protein

BACK







































Question # 36 (Multiple Choice) Sudden-onset of severe shortness-of-breath and coughing -- awakening the patient

Answer: (B) paroxysmal dyspnea (nocturnal)

BACK







































Question # 37 (Multiple Choice) Fundamental abnormality and heart failure -- embodied in:

Answer: (C) both

BACK







































Question # 38 (Multiple Answer) Precipitating causes of congestive heart failure:

(A) AV dissociation

(B) severe bradycardia

(C) reduce synchrony of ventricular contraction

(D) tachyarrhythmias

BACK







































Question # 39 (Multiple Answer) Factors influencing end-diastolic volumes:

(A) volume depletion

(B) body position

(C) venous tone

(D) skeletal muscle activity

(E) uterine contraction

BACK







































Question # 40 (Multiple Choice) Factor(s) affecting microvascular blood flow:

Answer: (C) both

BACK







































Question # 41 (Multiple Choice) Bipyridines -- phosphodiesterase inhibitors used in CHF:

Answer: (B) amrinone (Inocor)

BACK







































Question # 42 (Multiple Choice) Cardiac output is directly dependent upon:

Answer: (D) heart rate and stroke volume

BACK