WGU D027 PATHOPHARMACOLOGICAL
ADVANCED FOUNDATIONS EXAM REVIEW
STUDY NOTES
◉ Echocardiogram.
Answer: Diagnostic tool, evaluates heart structure and function
◉ At Risk for HF - Stage A.
Answer: no structural heart disease or symptoms of heart failure
◉ Stage A HF co-morbidities.
Answer: htn, atherosclerotic disease, diabetes, metabolic syndrome,
patients using cardiotoxins with family history
◉ Therapy goals of stage A HF.
Answer: treat htn, encourage smoking cessation, encourage regular
exercise, treat lipid disorders, discourage alcohol intake/drug use,
control metabolic syndrome
Meds: ACEI or Angiotensin II RB for vascular disease or diabetes
(avapro, losartan, benicar, diovan, etc)
◉ At Risk for HF - Stage B.
,Answer: structural heart disease but no symptoms of heart failure
◉ Stage B HF co-morbidities.
Answer: previous MI, LV remodeling with LV hypertrophy and low
EF, asymptomatic valvular disease
◉ Therapy goals of Stage B HF.
Answer: Meds: ACEI or ARB, Beta-blockers, inplantable defibrillators
◉ Stage C heart failure.
Answer: structural heart disease with prior or current symptoms of
HF
◉ Presentation of Stage C HF.
Answer: known structural heart disease and shortness of breath and
fatigue, reduced exercise tolerance
◉ Therapy for Stage C HF.
Answer: dietary salt restriction, MEDS: diuretic, ACEI, beta blockers.
Some patients: aldosterone antagonist, ARBs, digitalis,
hydralazine/nitrates, biventricular pacing, inplantable defibrillators
◉ Stage D heart failure.
, Answer: refractory HF requiring specialized interventions
◉ Presentation of Stage D HF.
Answer: marked symptoms at rest despite maximal medical therapy
(recurrently hospitalized or cannot be safely discharged without
specialized interventions)
◉ Therapy goals for Stage D HF.
Answer: compassionate end-of-life care/hospice, extraordinary
measures ,heart transplant, chronic inotropes, permanent
mechanical support, experimental drugs or surgery
◉ Ischemic heart Disease (CAD, MI) presentation.
Answer: chest discomfort, pain in neck/jaw/chest (crushing,
squeezing, sharp), pain worse with exertion (demand requirement is
higher), abnormal heart sounds, hypoxia, arrhythmias (afib, ST
elevation)
◉ Stable angina goal.
Answer: decrease cardiac oxygen demand
◉ Meds for stable angina.
Answer: nitro first choice, then beta blockers (beta blockers if
angina occurs with effort)
ADVANCED FOUNDATIONS EXAM REVIEW
STUDY NOTES
◉ Echocardiogram.
Answer: Diagnostic tool, evaluates heart structure and function
◉ At Risk for HF - Stage A.
Answer: no structural heart disease or symptoms of heart failure
◉ Stage A HF co-morbidities.
Answer: htn, atherosclerotic disease, diabetes, metabolic syndrome,
patients using cardiotoxins with family history
◉ Therapy goals of stage A HF.
Answer: treat htn, encourage smoking cessation, encourage regular
exercise, treat lipid disorders, discourage alcohol intake/drug use,
control metabolic syndrome
Meds: ACEI or Angiotensin II RB for vascular disease or diabetes
(avapro, losartan, benicar, diovan, etc)
◉ At Risk for HF - Stage B.
,Answer: structural heart disease but no symptoms of heart failure
◉ Stage B HF co-morbidities.
Answer: previous MI, LV remodeling with LV hypertrophy and low
EF, asymptomatic valvular disease
◉ Therapy goals of Stage B HF.
Answer: Meds: ACEI or ARB, Beta-blockers, inplantable defibrillators
◉ Stage C heart failure.
Answer: structural heart disease with prior or current symptoms of
HF
◉ Presentation of Stage C HF.
Answer: known structural heart disease and shortness of breath and
fatigue, reduced exercise tolerance
◉ Therapy for Stage C HF.
Answer: dietary salt restriction, MEDS: diuretic, ACEI, beta blockers.
Some patients: aldosterone antagonist, ARBs, digitalis,
hydralazine/nitrates, biventricular pacing, inplantable defibrillators
◉ Stage D heart failure.
, Answer: refractory HF requiring specialized interventions
◉ Presentation of Stage D HF.
Answer: marked symptoms at rest despite maximal medical therapy
(recurrently hospitalized or cannot be safely discharged without
specialized interventions)
◉ Therapy goals for Stage D HF.
Answer: compassionate end-of-life care/hospice, extraordinary
measures ,heart transplant, chronic inotropes, permanent
mechanical support, experimental drugs or surgery
◉ Ischemic heart Disease (CAD, MI) presentation.
Answer: chest discomfort, pain in neck/jaw/chest (crushing,
squeezing, sharp), pain worse with exertion (demand requirement is
higher), abnormal heart sounds, hypoxia, arrhythmias (afib, ST
elevation)
◉ Stable angina goal.
Answer: decrease cardiac oxygen demand
◉ Meds for stable angina.
Answer: nitro first choice, then beta blockers (beta blockers if
angina occurs with effort)
