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Medical Pharmacology Practice Test Questions:   Pathophysiology and Pharmacological Management in Congestive Heart Failure

 

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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