Heart failure
General Medicine · Topic 1
Source: NMC CBME Curriculum 2024 · Volume II · General Medicine · Topic 1 · combined PDF page 281
Practice questions
- In the primary-care pathway described for adults aged 50–79 years with suspected heart failure, which NT-proBNP value is the recommended age-specific threshold?
- An 84-year-old is assessed in primary care for possible heart failure. According to the cited pathway, which NT-proBNP threshold applies to the age group of 80 years and older?
- A 67-year-old with fatigue has an elevated NT-proBNP in the primary-care pathway described in the cited position paper. Which tests are identified as essential confirmatory testing for diagnosis and management planning?
- Which patient characteristic is specifically listed in the cited primary-care position paper as a reason to consider NT-proBNP measurement in an adult over 50?
- A clinician is considering applying the cited NT-proBNP cutoffs to an adult outside the population and setting described in the position paper. Which interpretation is most appropriate?
- A patient has both chronic kidney disease and heart failure. Which statement best reflects the KDIGO conference conclusions about their relationship?
- A patient with heart failure and chronic kidney disease has a small decline in kidney function after initiation of guideline-directed heart-failure therapy. According to the KDIGO conference conclusions, what is the best general interpretation?
- Which group of therapies is identified in the KDIGO conference report as potentially beneficial in both heart failure and chronic kidney disease, while evidence in advanced CKD remains limited?
- In a patient with heart failure and CKD, which approach to interpreting natriuretic peptides and serum creatinine is most consistent with the KDIGO conference report?
- A care team is planning long-term management for a patient with both heart failure and CKD. Which overarching approach is emphasized by the KDIGO conference?
- In adults with HFpEF, albuminuria was consistently associated in a systematic review with which outcome pattern?
- A patient with HFpEF has albuminuria but relatively preserved estimated kidney function. Which statement best reflects the systematic review's finding about its prognostic value?
- Which interpretation of albuminuria in HFpEF is best supported by the systematic review?
- A systematic review of adults with HFpEF included studies using different methods to assess urinary protein. Which conclusion about the prognostic association was reported?
- In heart failure, which interpretation of cardiac troponin is supported by the reviewed literature?
- Why might repeated cardiac troponin measurements be considered during follow-up of a patient with heart failure?
- A proposed remote-monitoring system for heart failure combines troponin with BNP or NT-proBNP, ECG, kidney function, symptoms, and wearable data. Which interpretation best matches the review?
- Which statement best describes the current limitations of point-of-care cardiac troponin biosensors for heart-failure monitoring?
- A patient has a pleural effusion of uncertain cause, and heart failure is in the differential diagnosis. Which biomarker group has high diagnostic accuracy for heart-failure-related pleural effusion in the reviewed literature?
- Which statement about ischaemia-modified albumin, CCL22, apolipoprotein E, and soluble urokinase plasminogen activator receptor in pleural-effusion assessment is best supported by the review?
- Which pleural-effusion scoring systems are described as the most promising in the review of heart-failure-related effusions?
- Imaging and echocardiography do not clearly establish the cause of a pleural effusion. Which next interpretation is most consistent with the reviewed evidence?
- A review reports diagnostic accuracy of natriuretic peptides for heart-failure-related pleural effusion. Which conclusion is most defensible?
- A review of fermentable fiber and HFpEF describes possible benefits mediated by short-chain fatty acids. Which mechanism is included in the proposed rationale?
- A clinician cites human randomized trials of fermentable fiber to claim that fiber is proven to reduce HFpEF hospitalization. Which response best reflects the systematic review?
- What human-trial effects of fermentable-fiber interventions are summarized in the review, without establishing HFpEF-specific clinical benefit?
- Which conclusion about direct short-chain fatty-acid supplementation is supported by the review?
- A patient with HFpEF asks whether increasing fermentable fiber is an established disease-modifying treatment. What is the most evidence-aligned response based on the review?