A 58-year-old male has come to your primary care center for establishment of care. His medical problems include heart failure with preserved ejection fraction and hypertension. As you review his medications, you want to make sure he is on the right medications which would be beneficial in the long run. Which of the following medications are known to decrease mortality in patients with heart failure with preserved ejection fraction?
A 58-year-old male has come to your primary care center for establishment of care. His medical problems include chronic systolic heart failure and hypertension. As you review his medications, you want to make sure he is on the right medications which would be beneficial in the long run. Which of the following medications are known to decrease mortality in patients with chronic heart failure?
A 66-year-old female is brought to the emergency room who has been suffering from substernal chest pain. Her ECG showed ST segment elevation. Laboratory tests reveal elevated troponin. Echocardiogram showed an ejection fraction of 35%. She was treated with coronary angioplasty and transferred to the recovery room. Of the following, which medication should be initiated in this patient that has proved to reduce mortality in post-myocardial infarction patients?
A 55 year-old man comes to your office with complaints of gradual breast enlargement over the past 3 months. He has mild tenderness in both breasts, more pronounced on the left side. He also describes psychological discomfort about his appearance, explaining the feelings of embarrassment. His medical history is significant for hypertension, chronic heart failure (NYHA Class II), and type 2 diabetes mellitus. His current medications include spironolactone, metoprolol, metformin, furosemide and aspirin. He does not consume alcohol excessively and denies use of anabolic steroids or recreational drugs. He has no family history of breast cancer or hormonal disorders. On physical examination, you notice a well-appearing male. His blood pressure is 128/80 mm Hg and heart rate is 72 bpm. He has enlarged breasts, but no discharge or lumps. There is mild tenderness on palpation of both breasts. There is no nipple retraction or discharge. Which of his current medications most likely caused his breast condition?
A 55 year-old male comes to your office for the management of hypertension, chronic heart failure and type 2 diabetes mellitus. His current medications include spironolactone, metformin, metoprolol and furosemide. While you discuss spironolactone, he asks you about the common side effects of spironolactone he should be aware of. Which of the following common side effects is associated with spironolactone?
A 53 year-old woman with heart failure comes to your cardiology clinic for a follow up. She googled about aldosterone antagonists and got some information about their use in heart failure. Concerning aldosterone antagonists use in heart failure, which of the following is a true statement?
A 58-year-old man presents to your office with progressive dyspnea over the last three months. Previously, he had been able to work in his farm and take care of his cows, but now he feels short of breath after walking only 50 feet. He does not have chest pain at rest but has experienced retrosternal chest pressure with strenuous work. His sleep is also not ‘peaceful’ because he wakes up at night feeling short of breath, which is relieved within minutes by sitting upright in bed. On physical examination, he is afebrile, with a heart rate of 88 beats per minute (bpm), blood pressure of 145/92 mm Hg, and respiratory rate of 18 breaths per minute. On cardiac examination, his heart rhythm is regular with a normal S1 and S2 with a systolic murmur loudest over the second right intercostal space. He also has elevated jugular venous pressure (JVP), pedal edema and bilateral crackles in lungs. Echocardiogram reveals an ejection fraction of 30% and aortic stenosis. Which of the following medications is shown to improve long-term survival in this patient?
A 64 year-old female has come to your office for the follow-up of her resistant hypertension. You would like to add a selective β1 blocker to her current medications to treat her hypertension. Of the following, which action is not caused by a selective β1 blocker when given in normal doses?
A white 68 year-old woman presents to the primary care center for establishment of care. Her medical history is significant for heart failure with an ejection fraction of 38%. Her current medications include torsemide 40 mg and enalapril 2.5 mg. Her shortness of breath improved a lot since she started to take these medications. Of the following, which medication, if added to this patient’s current medications, would reduce her heart failure-related mortality?
