Chapter·Internal MedicineHeart failure

Guideline-directed medical therapyDownloads

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Sample Questions

1

A 55-year-old male is hospitalized for acute heart failure. The patient has a 20-year history of alcoholism and was diagnosed with diabetes mellitus type 2 (DM2) 5 years ago. Physical examination reveals ascites and engorged paraumbilical veins as well as 3+ pitting edema around both ankles. Liver function tests show elevations in gamma glutamyl transferase and aspartate transaminase (AST). Of the following medication, which most likely contributed to this patient's presentation?

AGlargine

BPramlintide

CPioglitazone

DGlipizide

EMetformin

2

A 70-year-old Caucasian male visits your office regularly for treatment of New York Heart association class IV congestive heart failure. Which of the following medications would you add to this man's drug regimen in order to improve his overall survival?

ASpironolactone

BFurosemide

CAmiloride

DAcetazolamide

EHydrochlorothiazide

3

A 46-year-old African American man presents to the physician with dyspnea on exertion for the past 2 months. He also has occasional episodes of coughing at night. He says that he has been healthy most of his life. He is a non-smoker and a non-alcoholic. He does not have hypercholesterolemia or ischemic heart disease. His father died due to congestive heart failure. On physical examination, the pulse rate was 116/min, the blood pressure was 164/96 mm Hg, and the respiratory rate was 20/min. Chest auscultation reveals bilateral fine crepitations at the lung bases. A complete diagnostic work-up suggests a diagnosis of hypertension with heart failure due to left ventricular dysfunction. Which of the following drug combinations is most likely to benefit the patient?

AAmlodipine-Atenolol

BAmlodipine-Valsartan

CMetoprolol-Atorvastatin

DIsosorbide dinitrate-Hydralazine

EAtenolol-Hydrochlorothiazide

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