A patient of CHF was treated with furosemide and digoxin. He became symptom-free and is stable for the last 3 months with resting heart rate 68/min in sinus rhythm but left ventricular ejection fraction is low. Which of the following lines of action is warranted: A. Stop above medication and start an ACE inhibitor B. Continue all medication as before C. Continue the diuretic but stop digoxin D. Continue digoxin but stop the diuretic

A patient of CHF was treated with furosemide and
digoxin. He became symptom-free and is stable for
the last 3 months with resting heart rate 68/min in
sinus rhythm but left ventricular ejection fraction is
low. Which of the following lines of action is warranted:
A. Stop above medication and start an ACE
inhibitor
B. Continue all medication as before
C. Continue the diuretic but stop digoxin
D. Continue digoxin but stop the diuretic
by

1 Answer

Answer :

A. Stop above medication and start an ACE
inhibitor
by

Related questions

What is the usual response to digoxin in a patient of atrial fibrillation: A. Restoration of normal sinus rhythm B. Conversion of atrial fibrillation to atrial flutter C. Increase in atrial fibrillation frequency, but decrease in ventricular rate D. Decrease in atrial fibrillation frequency, but increase in ventricular rate

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Last Answer : C. Increase in atrial fibrillation frequency, but decrease in ventricular rate

Choose the correct statement about use of βadrenergic blockers in CHF: A. All β blockers are equally effective in CHF B. They are used as alternative to conventional therapy with ACE inhibitors ± digitalis/ diuretic C. They are most useful in mild to moderate cases with systolic dysfunction due to dilated cardiomyopathy D. They are indicated only in asymptomatic left ventricular dysfunction

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Last Answer : C. They are most useful in mild to moderate cases with systolic dysfunction due to dilated cardiomyopathy

Infusion of potassium chloride is indicated in digitalis toxicity when the manifestation(s) is/are: A. Vomiting, hyperapnoea and visual disturbance B. Pulsus bigeminus with heart rate 110/min in a patient on maintenance digoxin therapy C. Ventricular tachycardia in a child who has accidentally ingested 10 digoxin tablets D. 2:1 A-V block with occasional ventricular extrasystoles

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Last Answer : B. Pulsus bigeminus with heart rate 110/min in a patient on maintenance digoxin therapy

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Which of the following patients are at the highest risk of suffering from an adverse drug reaction? a) An 8 month year old infant receiving a prescription for an antibiotic. b) A 22 year old patient with asthma receiving prescriptions for inhalers to relieve and prevent their asthma. c) A 48 year old patient who has hypertension and receives a prescription for an ACE Inhibitor. d) A 68 year old patient who has oedema receiving a prescription for a diuretic.

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A patient of liver cirrhosis with ascitis was treated with hydrochlorothiazide 50 mg twice daily. He responded initially, but over a couple of months the diuretic action gradually diminished and ascitis again appeared. Select the measure to reinduce diuresis: A. Increase hydrochlorothiazide dose to 100 mg twice daily B. Add acetazolamide 250 mg twice daily C. Add spironolactone 50 mg thrice daily D. Substitute hydrochlorothiazide by spironolactone 50 mg 6 hourly

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Which of the following drugs can afford both haemodynamic improvement as well as disease modifying benefits in CHF: A. Furosemide B. Milrinone C. Losartan D. Digoxin

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In a patient of hypertension, the dose of propranolol that normalized blood pressure, reduced resting heart rate to 50/min. Which of the following β blockers will be most suitable for him as an alternative so that heart rate is not markedly reduced: A. Pindolol B. Celiprolol C. Bisoprolol D. Atenolol

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Last Answer : B. Heart rate and symptoms of CH

A 40-year-old politician suffered from attacks of chest pain diagnosed as angina pectoris. He had a tense personality, resting heart rate was 96/min, blood pressure 170/104 mm Hg, but blood sugar level and lipid profile were normal. Select the most suitable antihypertensive for initial therapy in his case: A. Nifedipine B. Hydrochlorothiazide C. Atenolol D. Methyldopa

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The following apply to use of spironolactone in CHF except: A. It is indicated only in NYHA class III/IV cases as additional drug to conventional therapy B. It affords prognostic benefit in severe heart failure over and above that afforded by ACE inhibitors C. It helps overcome refractoriness to diuretics D. It affords rapid symptomatic relief

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A patient of acute myocardial infarction being treated in intensive care unit developed left ventricular failure with raised central venous pressure. It was decided to use glyceryl trinitrate. Which route/method of administration would be most suitable: A. Sublingual B. Oral C. Intravenous bolus injection D. Slow intravenous infusion

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Beneficial effects of β-adrenoceptor blockers in CHF include the following except: A. Antagonism of ventricular wall stress enhancing action of sympathetic overactivity B. Antagonism of vasoconstriction due to sympathetic overactivity C. Prevention of pathological remodeling of ventricular myocardium D. Prevention of dangerous cardiac arrhythmias

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Last Answer : B. Antagonism of vasoconstriction due to sympathetic overactivity

Quinidine can cause paradoxical tachycardia in a patient of: A. Sick sinus syndrome B. Atrial extrasystoles C. Atrial fibrillation D. Ventricular extrasystoles

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Last Answer : C. Atrial fibrillation

Quinidine is now used primarily for (a) Conversion of auricular fibrillation to sinus rhythm (b) Control of ventricular rate in atrial flutter (c) Termination of ventricular tachycardia (d) Prevention of recurrences of atrial and ventricular extrasystoles/tachycardias

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Last Answer : Ans: D

Which vasodilator is most suitable for a patient of CHF who is symptomatic even at rest and has a central venous pressure of 25 mm Hg and cardiac index 1.8 L/min/m2 : A. Glyceryl trinitrate B. Enalapril C. Hydralazine D. Nifedipine

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Last Answer : B. Enalapril

Nonsteroidal antiinflammatory drugs reduce the diuretic action of furosemide by: A. Preventing prostaglandin mediated intrarenal haemodynamic actions B. Blocking the action in ascending limb of loop of Henle. C. Enhancing salt and water reabsorption in distal tubule D. Increasing aldosterone secretion

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Last Answer : A. Preventing prostaglandin mediated intrarenal haemodynamic actions

Select the diuretic which is orally active, efficacious in acidosis as well as alkalosis, causes diuresis even in renal failure and has additional carbonic anhydrase inhibitory action: A. Mannitol B. Benzthiazide C. Indapamide D. Furosemide

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Intravenous furosemide promptly mitigates dyspnoea in acute left ventricular failure by: A. Producing bronchodilatation B. Causing rapid diuresis and reducing circulating blood volume C. Increasing venous capacitance and reducing cardiac preload. D. Stimulating left ventricular contractility

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Digoxin is contraindicated in: A. Angina pectoris patients B. Ventricular tachycardia C. Hypertensive patients D. Complete heart-block

Description : Digoxin is contraindicated in: A. Angina pectoris patients B. Ventricular tachycardia C. Hypertensive patients D. Complete heart-block

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The following diuretic reduces positive free water clearance but does not affect negative free water clearance: A. Hydroflumethiazide B. Furosemide C. Ethacrynic acid D. Mannitol

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Last Answer : A. Hydroflumethiazide

The following drug can relieve symptoms of CHF but does not retard disease progression or prolong survival: A. Digoxin B. Carvedilol C. Spironolactone D. Ramipril

Description : The following drug can relieve symptoms of CHF but does not retard disease progression or prolong survival: A. Digoxin B. Carvedilol C. Spironolactone D. Ramipril

Last Answer : A. Digoxin

Digoxin produces the following effect(s) in atrial flutter: A. Reduces ventricular rate B. Prevents shift of A-V block to a lower grade C. Converts atrial flutter to atrial fibrillation D. All of the above

Description : Digoxin produces the following effect(s) in atrial flutter: A. Reduces ventricular rate B. Prevents shift of A-V block to a lower grade C. Converts atrial flutter to atrial fibrillation D. All of the above

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Select the drug that can help restore cardiac performance as well as prolong survival in CHF patients: A. Spironolactone B. Furosemide C. Dobutamine D. Metoprolol

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Long-term maintenance therapy with digoxin is the best option in the following category of CHF patients: A. Hypertensive patients B. Patients with hypertrophic cardiomyopathy C. Patients with associated atrial fibrillation D. Patients having cardiac valvular defects

Description : Long-term maintenance therapy with digoxin is the best option in the following category of CHF patients: A. Hypertensive patients B. Patients with hypertrophic cardiomyopathy C. Patients with associated atrial fibrillation D. Patients having cardiac valvular defects

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Description : Digoxin affords the following benefit/benefits in CHF: A. Restores cardiac compensation and relieves symptoms B. Reverses the pathological changes of CHF C. Prolongs survival of CHF patients D. Both ‘A’ and ‘B’ are correc

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The HIV titer of an AIDS patient was found to be reduced but still detectable after 6 months of tripple drug anti-HIV therapy. The best course of action in this patient is: A. Continue the same 3 drugs for another 3 months B. Replace all 3 drugs with a set of another 3 drugs C. Replace 2 drugs and continue one previously used drug D. Replace one drug and continue two previously used drugs

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Select the diuretic which is similar in efficacy and pattern of electrolyte excretion to furosemide, but is 40 times more potent dose to dose: A. Piretanide B. Bumetanide C. Xipamide D. Metolazone

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For treating the patient with congestive heart failure (CHF), which of the following dosages of dopamine is selected for its positive inotropic effects? (a) 2.0 mg/kg/min (b) 5–10 mg/kg/min (c) 10–20 mg/kg/min (d) 40 mg/kg/min (e) 40 mg/kg/min

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A 55-year-old patient with severe posthepatitis cirrhosis is started on a diuretic for another condition. Two days later he is found in a coma. The drug most likely to cause coma in a patient with cirrhosis is (a) Acetazolamide (b) Amiloride (c) Furosemide (d) Hydrochlorothiazide (e) Spironolactone

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Last Answer : Ans: A

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