Heart Failure: ABFM practice questions

14 board-style questions on heart failure in the PulseMD family medicine question bank — physician-reviewed, written against current guidelines with the reference cited on each question. Two free samples below; the full set with answers, explanations, and spaced review is free to start.

Sample question 1

A 68-year-old man with heart failure presents with progressive dyspnea. Chest X-ray shows a large left-sided pleural effusion. Thoracentesis is performed, yielding straw-colored fluid. Pleural fluid analysis shows: protein 2.1 g/dL (serum protein 6.8 g/dL), LDH 95 IU/L (serum LDH 220 IU/L), and pleural fluid to serum LDH ratio 0.43. Using Light's criteria, how is this effusion classified?

1. Empyema
2. Transudative effusion
3. Complicated parapneumonic effusion
4. Exudative effusion

Sample question 2

A 68-year-old man with a history of COPD and hypertension presents to the emergency department with acute worsening dyspnea over 2 days. He has bilateral crackles on lung exam, jugular venous distension, and bilateral lower extremity pitting edema. His oxygen saturation is 89% on room air. Chest X-ray shows bilateral pulmonary vascular congestion and small bilateral pleural effusions. BNP level is 920 pg/mL. Which interpretation of the BNP result is most accurate?

1. This BNP level is nonspecific and likely elevated due to his COPD exacerbation
2. This BNP level is mildly elevated and suggests a non-cardiac cause of dyspnea
3. This BNP level is unreliable in patients with renal insufficiency
4. This BNP level strongly supports heart failure as a major contributor to his acute dyspnea

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