Question 1

Which of the following best defines heart failure?

Accepted Answer

A condition in which the heart cannot pump sufficient blood to meet the body's needs.

Question 2

Which formula correctly represents the calculation of ejection fraction (EF)?

Accepted Answer

$$EF = \frac{EDV - ESV}{EDV}$$

Question 3

A patient has an end-diastolic volume (EDV) of 120 mL and an end-systolic volume (ESV) of 60 mL. What is their ejection fraction (EF)?

Accepted Answer

$$EF = \frac{120 - 60}{120} = 0.5 or 50$$%

Question 4

Which of the following is NOT a common etiology of dilated cardiomyopathy (DCM)?

Accepted Answer

Chronic mitral stenosis

Question 5

According to the Frank-Starling law, what happens to stroke volume as end-diastolic volume increases, up to a physiological limit?

Accepted Answer

Stroke volume increases due to greater myocyte stretch and contractility.

Question 6

Which of the following best describes the pathophysiology of heart failure with reduced ejection fraction (HFrEF)?

Accepted Answer

Decreased contractility leads to incomplete ejection, increased end-diastolic volume, and ventricular dilation.

Question 7

Which neurohormonal pathway is initially compensatory but ultimately maladaptive in HFrEF?

Accepted Answer

Chronic β-adrenergic receptor stimulation

Question 8

What is the primary effect of chronic β-adrenergic receptor hyperactivation in heart failure?

Accepted Answer

Receptor internalization and decreased cAMP-PKA signaling

Question 9

Which of the following is a hallmark feature of Takotsubo cardiomyopathy?

Accepted Answer

Apical akinesis with ballooning of the left ventricle

Question 10

A 60-year-old woman presents with acute chest pain after a major emotional event. Imaging shows apical ballooning of the left ventricle, but her coronary arteries are normal. What is the most likely diagnosis?

Accepted Answer

Takotsubo cardiomyopathy

Question 11

Which of the following is a typical diagnostic finding in heart failure with reduced ejection fraction (HFrEF)?

Accepted Answer

Elevated natriuretic peptides (BNP or NT-proBNP)

Question 12

Which treatment is primarily used for symptom relief in HFrEF by controlling volume overload?

Accepted Answer

Diuretics

Question 13

Which of the following best explains why β-blockers are beneficial in the management of HFrEF?

Accepted Answer

They block maladaptive chronic β-adrenergic stimulation, reducing remodeling.

Question 14

A patient with HFrEF has a stroke volume (SV) of 50 mL and an end-diastolic volume (EDV) of 120 mL. Calculate the ejection fraction (EF).

Accepted Answer

$$EF = \frac{50}{120} = 0.42 or 42$$%

Question 15

Which of the following is a common clinical symptom of heart failure?

Accepted Answer

Dyspnea (shortness of breath)

Question 16

Which of the following mechanisms explains the initial compensatory effect of neurohormonal activation in heart failure?

Accepted Answer

Increased β-adrenergic drive increases heart rate and contractility.

Question 17

Which of the following is NOT a typical finding in dilated cardiomyopathy?

Accepted Answer

Increased ejection fraction

Question 18

Which adrenergic receptor subtype is most abundant in the heart and primarily responsible for increasing contractility?

Accepted Answer

β1-adrenergic receptor

Question 19

A patient with Takotsubo cardiomyopathy is most likely to have which of the following triggers?

Accepted Answer

Acute emotional or physical stress

Question 20

Which of the following best describes the effect of high local catecholamine concentrations in Takotsubo cardiomyopathy?

Accepted Answer

Stimulates β2-adrenergic receptors to decrease contractility at the apex

Heart Failure: Pathophysiology, Diagnosis, and Special Syndromes

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