11 board-style questions on heart failure in the PulseMD family medicine question bank, 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.
A 62-year-old man with heart failure with reduced ejection fraction (EF 28%) is on lisinopril 20 mg daily, carvedilol 25 mg twice daily, and spironolactone 25 mg daily. His blood pressure is 118/72 mmHg, heart rate is 64 bpm, potassium is 4.5 mEq/L, and creatinine is 1.1 mg/dL. He remains symptomatic with NYHA class II dyspnea on exertion. What medication change is most likely to improve his outcomes?
A 74-year-old woman with hypertension, obesity (BMI 34), and type 2 diabetes presents with progressive exertional dyspnea and bilateral lower extremity edema over 3 months. Echocardiogram shows an ejection fraction of 62%, left atrial enlargement, grade II diastolic dysfunction, and estimated RVSP of 42 mmHg. BNP is 310 pg/mL. She is currently on lisinopril and furosemide. Which medication has the strongest evidence for reducing heart failure hospitalizations in her condition?
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