1. Which statement is true in relation to the prevalence of heart

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1. Which statement is true in relation to the prevalence of heart failure. Choose it!
a. The prevalence of heart failure in the adult population is between 1-2 % and shows a
downward trend.
b. The prevalence of heart failure in the adult population is between 4-5 % and shows
an upward trend.
a. The prevalence of heart failure in the adult population is between 1-2 % and shows
an upward trend.
c. The prevalence of heart failure in the adult population is between 4-5 % and shows a
downward trend.
2. Characteristics of patients classified as functional class IV. according to the „New York
Heart Association” (NYHA):
Ordinary physical activity cause fatigue, palpitation, or dyspnea
The patient's condition can only be stabilized via intravenous inotropic therapy
Unable to carry out any physical activity without discomfort, symptoms of cardiac
insufficiency at rest
ACE inhibitor and beta-blockers can not be applied in this case
3. Characteristics of skeletal muscle in a heart failure patient:
a. Stuctural changes in the sceletal muscle with increase of type IIb fibers
b. Biochemical alteration
c. Ergoreflex alteration
d. All of the above
4. From the following sentences one is not true. Choose it!
a. BNP is mainly released from the right ventricle at elevated filling pressure
b. ARB-s are act on ATII AT1 receptors
c. In heart failure beta-receptor down regulation is observed
d. Excessive diuretic treatment enhance the activation of the sympathetic nervous
5. Brain natriuretic peptide (BNP) is secreted primarily from the brain during heart failure,
therefore it is of considerable importance in the diagnosis of heart failure.
a. True-true
b. False-false
c. True-false
d. False-true
6. From the following sentences which one is true?
a. RAAS system activation is of decisive importance in the pathogenesis of heart
b. During heart failure the number of beta-receptors rises (upregulation)
c. Sympathetic nervous system activation only occurs in end-stage disease
d. All 3 statements above are true
7. In the treatment of heart failure the following statement is true:
a. Digitals therapy improve survival, and patients become less symptomatic
b. ACE inhibitor reduce the risk of HF hospitalization but increase the risk of
premature death.
c. Beta-blocker reduce the risk of HF hospitalization and the risk of premature
d. Mineralocorticoid antagonist only indicated in severe, refractory cases
8. In the treatment of heart failure the following statement is true:
1. Digitalis is indicated in all systolic heart failure patients
2. ACE inhibitor is always indicated if no contraindication present
3. Beta-blockers not indicated in high dose, because it has a negative inotropic
4. Ca-antagonist is always indicated
9. Which statement is true in case of diastolic heart failure (HFpEF)?
a. Diastolic heart failure (HFpEF) is common, it occurs in 10-20% of heart failure
b. Usually these patients are elderly, diabetic, obes, hypertensive and women
c. Evidences are available when choosing its treatment
d. All 3 statements above are true
10. Thallium reinjection scintigraphy in mainly used in the diagnosis of heart failure:
a. The separate of viable (hibernating) myocardium from necrosis
b. Detection of previous myocardial infarction
c. Imaging of Coronary Artery Calcium
d. Determination of left ventricular systolic function
11. What does it mean class „I. A” recommendation?
a. Intervention is not useful/effective and may be harmful
b. Intervention is useful and effective, data derived from multiple randomized
clinical trials
c. Chinidin or other class I. A type antiarrythmic medication therapy is indicated
d. Intervention is useful based on expert, consensus opinion
12. What medicine can be given to a pregnant woman with heart failure?
a. Beta-blocker, alpha-methyl dopa, diuretic
b. Beta-blocker, ACE inhibitor, diuretic
c. Digoxin, diuretic, ACE inhibitor
d. Diuretic, ARB, beta-blocker
13. In the diagnosis/prognostics of heart failure the following biomarkers can be applied:
a. Natrium, CN, Creatinin
b. Troponin, CK
c. Galectin-3, BNP, NT-ProBNP
d. Blood sugar, LDL-cholesterol, CRP
14. It is important for a person with heart failure to:
a. Make sure they get the flu shot every year
b. Receive the pneumovax vaccination to prevent pneumonia
c. See their heart failure doctor regularly
d. All of the above
15. 1The recommended total daily amount of sodium that persons with heart failure should
eat is:
a. About 3,000 milligrams
b. More than 2,500 milligrams
c. Less than 2,000 milligrams
b. 500 milligrams
16. If a person with heart failure has a headache or pain, which would be the best medicine
to take?
a. Aspirin
b. Acetaminophen
d. Morphin
17. How often should a person with heart failure exercise?
a. Every week
b. Every day
c. Exercise is contraindicated in heart failure
b. 2-3 times per week
18. Persons with heart failure should call their doctor if they have which of the following
a. Weight gain of 2-3 kg in 1-2 days
b. Increased swelling of the ankles and/or stomach
c. More shortness of breath
b. All of the above
19. The best time of day for persons with heart failure to weigh themselves is:
a. At bedtime
b. Upon awakening in the morning
c. At or around lunchtime
d. When they remember to do it
20. How often should a person with heart failure weigh themselves?
a. Every day
b. Every week
c. Every month
b. Once in a while
21. If a person with heart failure gains 2-3 pounds in a few days, this usually means he/she:
a. Is eating too many calories and gaining weight
b. Has extra water in the body
c. Needs to drink more fluid
d. Needs to be getting more exercise to burn calories
22. Calcium channel blocker which is contraindicated in HFrEF:
a. Amlodipine
b. Verapamil
c. Levosimendan
d. Bisoprolol
23. Resynchronization therapy (CRT) is clearly indicated (class I A):
a. For all patients with heart failure below EF 35%
b. In case of (RBBB)
c. In all cases of Left bundle branch block (LBBB)
b. In patients in sinus rhythm with a QRS duration of ≥120 ms, LBBB QRS
morphology, and an EF ≤35%
24. In the case of a patient with heart failure it is essential to determine when examining
myocardial ischemia:
a. The localization of ischemia
b. The extent of ischemia
c. The presence of necrotic or hibernating myocardium
d. All of the above
25. On the basis of the latest guideline, what are the first-line drugs in the treatment of
chronic systolic heart failure?
a. ACE inhibitors + diuretics + beta-blockers
b. Digtalis + beta-blockers + mineralocorticoid receptor blockers
c. ACE inhibitors + beta-blockers + mineralocorticoid receptor blockers
d. Digitalis + diuretics + ACE inhibitors
26. In the outpatient heart failure service, according to the ESC Long-Term Registry data,
what percentage of patients achieving target dose of ACE inhibitors/ beta-blockers?
a. Above 50%
b. Below30%
c. Above30%
b. Below20%
27. Which drug combination is contraindicated in case of heart failure?
a. Beta-blocker + ACE inhibitor + mineralocorticoid receptor antagonist (MRA)
b. ACE inhibitor + MRA + angiotensin receptor blocker
c. beta-blocker + ACE inhibitor + ivabradin
d. ACE inhibitor + beta-blocker + digoxin
28. Regarding the use of beta-blockers when heart failure is associated with COPD:
a. It is not recommended
b. It has no restrictions
c. Beta-1 selective blockers are preferable
b. Non-selective, with combined action is recommended (ie. carvedilol)
29. From the following which statement is not true? Diuretic resistance…
a. … is common and occurs in one in three heart failure patients especially from
moderate to severe heart failure
b. … may be worsened by NSAIDs, which - through the inhibition of prostaglandin
synthesis - reduce renal perfusion and this way inhibit the effect of diuretics
c. … means that on the "usual" dose diuretic therapy the hyperhydration of the
extracellular space is not reduced
d. … is very rare, only occurs when heart failure is combined with severe kidney
30. From the following sentences only one is true. Choose it!
The strength of heart muscle contractions can be increased by:
a. Reducing the concentration of intracellular Ca2+ of heart muscle cells
b. The activation of beta-adrenergic signaling system of heart muscle cells
c. Increasing plasma K+ concentrations
d. Increasing the concentration of intracellular inorganic phosphate of heart muscle
31. 64 years old woman has chronic systolic heart failure. Her ejection fraction is 30%, in
NYHA II. She received enalapril 20 mg b.i.d., bisoprolol 10 mg o.d., eplerenone 50 mg o.d.
and furosemide 40 mg at stable dose more than 3 months. Her ECG shows sinus rhythm,
typical LBBB, QRS 150 msec and her heart rate is 78 min-1. She has not fluid retention. Her
NTproBNP level is 2000 pg/ml. What is the next step?
a. To increase the dose of furosemide
b. ICD implantation
c. CRT-D implantation
d. Introduction of ivabradine
32. Which is NOT part of the patient’s self-care management?
a. Avoid excessive fluid intake
b. Introduce and titrate neurohormonal antagonists
c. Perform exercise training regularly
d. Understand indications, dosing and effects of drugs

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