CHF

Question 1

What is the role of loop diuretics in CHF?

Answer 1

Relieve fluid overload and pulmonary congestion; no survival benefit.

Question 2

Name examples of loop diuretics used in CHF.

Answer 2

Furosemide

Question 3

What is the role of thiazide diuretics in CHF?

Answer 3

Used in mild CHF or combined with loop diuretics for resistant edema.

Question 4

What is the mechanism of ACE inhibitors in CHF?

Answer 4

Block conversion of angiotensin I to II → reduce preload and afterload

Question 5

Name examples of ACE inhibitors used in CHF.

Answer 5

Enalapril

Question 6

What is the role of ARBs in CHF?

Answer 6

Alternative to ACE inhibitors when cough/angioedema occurs; block AT1 receptors

Question 7

Name examples of ARBs used in CHF.

Answer 7

Losartan

Question 8

What is the role of ARNIs in CHF?

Answer 8

Sacubitril/valsartan enhances natriuretic peptides + blocks RAAS → superior to ACE inhibitors in reducing mortality and hospitalization.

Question 9

What is the role of β‑blockers in CHF?

Answer 9

Reduce sympathetic drive

Question 10

Which β‑blockers are proven in CHF?

Answer 10

Carvedilol

Question 11

What is the role of mineralocorticoid antagonists in CHF?

Answer 11

Block aldosterone → reduce fibrosis and remodeling

Question 12

Name examples of mineralocorticoid antagonists.

Answer 12

Spironolactone

Question 13

What is the role of SGLT2 inhibitors in CHF?

Answer 13

Improve outcomes in HFrEF regardless of diabetes status; reduce hospitalization and mortality.

Question 14

Name examples of SGLT2 inhibitors used in CHF.

Answer 14

Dapagliflozin

Question 15

What is the role of digoxin in CHF?

Answer 15

Provides symptomatic relief via positive inotropy and rate control in AF; no survival benefit.

Question 16

What are the key risks with digoxin?

Answer 16

Narrow therapeutic index

Question 17

What is the role of ivabradine in CHF?

Answer 17

Reduces HR by inhibiting funny current (If) in SA node; used if HR >70 despite β‑blocker therapy.

Question 18

What is the role of hydralazine + nitrates in CHF?

Answer 18

Reduce preload and afterload; especially useful in patients intolerant to ACE/ARB or in Black patients with HFrEF.

Question 19

Which drugs improve survival in CHF?

Answer 19

ACE inhibitors/ARNIs

Question 20

Which drugs provide only symptomatic relief in CHF?

Answer 20

Diuretics and digoxin.

Question 21

What device therapies are used in CHF?

Answer 21

ICD (prevents sudden death)

Question 22

What is the cornerstone of CHF pharmacotherapy?

Answer 22

Neurohormonal blockade with ACE/ARB/ARNI + β‑blocker + mineralocorticoid antagonist + SGLT2 inhibitor.