Congestive Heart Failure exam questions with
complete and accurate answers.
What is the definition of congestive heart failure? - Answer
Congestive heart failure is the syndrome in which the heart has
a reduced ability to fill or pump blood. This leads to a state
where the heart is not pumping enough blood to get tissues
adequate oxygen.
What are the four ways in which heart failure can be classified?
- Answer Heart failure can be classified as systolic or diastolic,
high output or low output, left sided or right sided, and acute or
chronic
What are the 6 major risk factors for the development of
congestive heart failure? - Answer Coronary artery disease,
hypertension, diabetes, valvular heart disease, cardiomyopathy,
and obesity
What is the equation for cardiac output? - Answer Cardiac
output is the heart rate multiplied by the stroke volume
What is the equation for stroke volume? - Answer Stroke
volume is the end diastolic volume minus the end systolic
volume
What is the definition of preload? - Answer Preload is the
pressure required to distend the ventricle to a given left
ventricular end diastolic volume
,What is the definition of afterload? - Answer Afterload is the
dynamic resistance against which the heart contracts
What is the pathophysiology of systolic heart failure? - Answer
The heart develops decreased contractility which leads to a
decreased ejection fraction. To compensate the body activates
the renin-angiotensin-aldosterone system, the sympathetic
nervous system, and released BNP from the ventricles.
What is the pathophysiology of diastolic dysfunction? - Answer
In diastolic dysfunction there is a decrease in ventricular
compliance and therefore a difficulty filling.
What are some of the conditions that can lead to decreased
ventricular compliance, and therefore to diastolic heart failure?
- Answer Hypertension leading to concentric wall thickening,
amyloidosis and hemochromatosis leading to chamber stiffness,
hypertrophic cardiomyopathy, and myocardial ischemia
How does heart failure lead to pulmonary congestion? - Answer
If there is left sided heart failure there can be a back up of fluid
into the lungs
What are some causes of high output heart failure, where the
cardiac output is elevated, but the heart can still not meet
metabolic demands? - Answer Causes of high output heart
failure of wet beri beri, hyperthyroidism, and AV malformation
,Most symptoms of heart failure are caused by pulmonary
congestion, what are some of these symptoms? - Answer
Dyspnea, orthopnea, paroxysmal nocturnal dyspnea, cough and
wheezing
If there is right sided heart failure leading to third spacing what
are some other clinical manifestations that may be observed? -
Answer Peripheral edema and weight gain
What are some of the causes of acute decompensated heart
failure? - Answer Myocardial infarction or arrhythmia, diet or
medication non-compliance, illness, and recent bleeding
What should be done on the physical examination when
congestive heart failure is suspected? - Answer The heart
should be auscultated, PMI palpated, jugular venous distention
checked, lungs auscultated, hepatojugular reflex checked, and a
peripheral exam to look for signs of edema
Which chemotherapy drugs are known for causing dilated
cardiomyopathy leading to CHF? - Answer Daunirubicin and
doxirubicin
If on cardiac auscultation there is an S3 heart sound heard,
what does this mean? - Answer S3 heart sound is the sound of
blood rushing into a partially filled ventricle indicating systolic
dysfunction
, If on cardiac auscultation is S4 heart sound is heard, what does
this mean? - Answer S4 heart sound indicates a stiffened
ventricle indicating diastolic dysfunction
If rales are heard on lung auscultation what does this signify? -
Answer Pulmonary edema
What virus is known for causing heart and pericardial
problems? - Answer Coxsackie virus
Although heart failure is typically diagnosed by the history and
physical, what are some of the diagnostic tests and imaging that
can be used? - Answer Chest x-ray, EKG, BNP level, and echo
What is considered to be a normal BNP level? - Answer A
normal BNP level is less than 100 pg per ml, and a level over
500 indicates that there is likely congestive heart failure
What exacerbating factor could make BNP levels higher than
they should be? - Answer Kidney failure
Should a CBC and CMP be done in patients with congestive
heart failure? - Answer Yes, these tests can help rule out
underlying causes or sequalae. LFTs can show if there is hepatic
congestion, electrolytes may be low, and with hemachromatosis
red blood cells may be extra elevated.
What is the mnemonic for the acute treatment of pulmonary
edema? - Answer LMNO:
complete and accurate answers.
What is the definition of congestive heart failure? - Answer
Congestive heart failure is the syndrome in which the heart has
a reduced ability to fill or pump blood. This leads to a state
where the heart is not pumping enough blood to get tissues
adequate oxygen.
What are the four ways in which heart failure can be classified?
- Answer Heart failure can be classified as systolic or diastolic,
high output or low output, left sided or right sided, and acute or
chronic
What are the 6 major risk factors for the development of
congestive heart failure? - Answer Coronary artery disease,
hypertension, diabetes, valvular heart disease, cardiomyopathy,
and obesity
What is the equation for cardiac output? - Answer Cardiac
output is the heart rate multiplied by the stroke volume
What is the equation for stroke volume? - Answer Stroke
volume is the end diastolic volume minus the end systolic
volume
What is the definition of preload? - Answer Preload is the
pressure required to distend the ventricle to a given left
ventricular end diastolic volume
,What is the definition of afterload? - Answer Afterload is the
dynamic resistance against which the heart contracts
What is the pathophysiology of systolic heart failure? - Answer
The heart develops decreased contractility which leads to a
decreased ejection fraction. To compensate the body activates
the renin-angiotensin-aldosterone system, the sympathetic
nervous system, and released BNP from the ventricles.
What is the pathophysiology of diastolic dysfunction? - Answer
In diastolic dysfunction there is a decrease in ventricular
compliance and therefore a difficulty filling.
What are some of the conditions that can lead to decreased
ventricular compliance, and therefore to diastolic heart failure?
- Answer Hypertension leading to concentric wall thickening,
amyloidosis and hemochromatosis leading to chamber stiffness,
hypertrophic cardiomyopathy, and myocardial ischemia
How does heart failure lead to pulmonary congestion? - Answer
If there is left sided heart failure there can be a back up of fluid
into the lungs
What are some causes of high output heart failure, where the
cardiac output is elevated, but the heart can still not meet
metabolic demands? - Answer Causes of high output heart
failure of wet beri beri, hyperthyroidism, and AV malformation
,Most symptoms of heart failure are caused by pulmonary
congestion, what are some of these symptoms? - Answer
Dyspnea, orthopnea, paroxysmal nocturnal dyspnea, cough and
wheezing
If there is right sided heart failure leading to third spacing what
are some other clinical manifestations that may be observed? -
Answer Peripheral edema and weight gain
What are some of the causes of acute decompensated heart
failure? - Answer Myocardial infarction or arrhythmia, diet or
medication non-compliance, illness, and recent bleeding
What should be done on the physical examination when
congestive heart failure is suspected? - Answer The heart
should be auscultated, PMI palpated, jugular venous distention
checked, lungs auscultated, hepatojugular reflex checked, and a
peripheral exam to look for signs of edema
Which chemotherapy drugs are known for causing dilated
cardiomyopathy leading to CHF? - Answer Daunirubicin and
doxirubicin
If on cardiac auscultation there is an S3 heart sound heard,
what does this mean? - Answer S3 heart sound is the sound of
blood rushing into a partially filled ventricle indicating systolic
dysfunction
, If on cardiac auscultation is S4 heart sound is heard, what does
this mean? - Answer S4 heart sound indicates a stiffened
ventricle indicating diastolic dysfunction
If rales are heard on lung auscultation what does this signify? -
Answer Pulmonary edema
What virus is known for causing heart and pericardial
problems? - Answer Coxsackie virus
Although heart failure is typically diagnosed by the history and
physical, what are some of the diagnostic tests and imaging that
can be used? - Answer Chest x-ray, EKG, BNP level, and echo
What is considered to be a normal BNP level? - Answer A
normal BNP level is less than 100 pg per ml, and a level over
500 indicates that there is likely congestive heart failure
What exacerbating factor could make BNP levels higher than
they should be? - Answer Kidney failure
Should a CBC and CMP be done in patients with congestive
heart failure? - Answer Yes, these tests can help rule out
underlying causes or sequalae. LFTs can show if there is hepatic
congestion, electrolytes may be low, and with hemachromatosis
red blood cells may be extra elevated.
What is the mnemonic for the acute treatment of pulmonary
edema? - Answer LMNO:
