PRETEST Acute Heart Failure

1. Common findings in Acute Heart Failure, except:

a. Pulmonary rales
b. Fixed split s2
c. S3 gallop
d. New onset holosystolic murmur

2. Below are the factors which could trigger acute heart failure, except :
a. Asthma bronchiale
b. Arrhytmia
c. Hypertensive emergency
d. Acute coronary syndrome

3. Which of the following is the most sensitive biomarker to rule out acute heart
failure?
a. BNP/ NT-proBNP
b. CKMB
c. Troponin T
d. Troponin I

4. BNP and NT-proBNP level which makes the diagnosis of acute heart failure
unlikely?
a. <35 / < 125
b. <50 / <150
c. <75 / < 200
d. <100 / <300

5. Followings are true for acute heart failure, except :

a. ACS could be the triggering factor
b. Worsening symptoms and signs of heart failure
c. Echocardiography is mandatory for diagnosis
d. The leading cause of hospitalization in the elderly

6. What is the optimal dose of Furosemide for patient with history of heart
failure presenting with congestion?
a. 40 mg
b. 60 mg
c. 80 mg
d. 2.5 times the patient’s routine dose

7. In a bradycardic patient with total AV block, what is needed as an initial

evaluation(s)?
a. The patient’s routine drug
b. Electrolytes level
c. Blood gas analysis
d. All of the above
8. Below are parameters that indicate poor organ perfusion, except?
a. Capillary refill time > 2s
b. Urin output 0.3 ml/kgBW/hour
c. Blood pressure 90/60
d. Cool, clammy skin

9. What is considered the first line anti hypertensive drug for acute heart failure
presenting with hypertensive emergency?
a. Nicardipine
b. Labetalol
c. Nitroglycerin
d. Diltiazem

10. A patient remains symptomatic after optimal dose of diuretic, b-blocker and
ACE-i. What's next?
a. Cardiac resynchronization therapy
b. Ivabradine
c. Mineralocorticoid receptor antagonist
d. Digoxin

11. A 70-year-old man comes with shortness of breath. Rales was found on
auscultation. BP 70/40, HR 140, RR 28. What is the appropriate initial
treatment?

a. Inotrope
b. Cardioversion
c. Defibrillation
d. Anticoagulant
12. All of the following can be found in chest xray of acute heart failure patient,
except
a. Batwing appearance
b. Pleural effusion
c. Interstitial edema
d. Silhouette sign

13. All are indications for urgent endotracheal intubation, except?

a. CPAP is inadequate
b. Respiratory failure
c. Cyanosis
d. Cardiac arrest (asystole)

14. 58 years old female presenting with shortness of breath. JVD +, Rales +/+, s3
+, edema +/+. BP 80/50, HR 122, RR 28, SpO2 90%. What is the appropriate
treatment for the patient?
a. O2, furosemide, nitroglycerin
b. Intubation, fluid challenge
c. O2, inotrope, vasopressor is needed, diuretic after adequate perfusion
d. O2, renal replacement therapy, vasopressor

15. Male, 55 years old presents with chest pain. Crackles +. BP 90/60, HR 105,
RR 22, SpO2 96%. ECG is done. What is the best treatment for the patient?

a. O2, furosemide, inotrope

b. O2, furosemide, inotrope, primary PCI
c. Dual antiplatelet, inotrope, furosemide
d. Dual anti platelet, high-dose statin, primary PCI
Answers:

1. C
2. A
3. A
4. D
5. C
6. D
7. D
8. C
9. C
10. C
11. D
12. B
13. C
14. C
15. D