General Medicine

20 learning units • 100 chapter sections • 200 explained questions. Assess the patient, choose investigations and build a monitored management plan across adult medical specialties.

Original RAHBAR study material for the Year 4 learning pathway. Clinical cases support supervised undergraduate learning. Treatment choices, doses and procedures must follow current local protocols and the responsible clinical team. References & further reading ↓

MODULE 03 / 20

Heart Failure & Congestion

Connect symptoms and examination with cardiac structure, volume status and a monitored treatment plan.

Answer all 10 questions, then submit to see your score and explanations. This is a self-study exercise; results are not saved.

Question 01. Which symptom particularly suggests pulmonary congestion when lying flat? A. DysuriaB. PhotophobiaC. Isolated tinnitusD. Orthopnoea

Question 02. What does echocardiography contribute to suspected heart failure? A. Direct measurement of medication adherenceB. Ventricular function and structural assessmentC. Exclusion of every pulmonary disorderD. Proof that all oedema is cardiac

Question 03. Does a preserved ejection fraction exclude heart failure? A. Yes, in every adultB. Only if ankle swelling is absentC. No, abnormal filling and compatible evidence may still establish itD. Yes, if the ECG is normal

Question 04. Which pair is important to monitor during diuretic treatment? A. Hair length and eye colourB. Hearing and shoe size aloneC. Kidney function and electrolytesD. Only the admission diagnosis

Question 05. What is a common precipitant of heart-failure deterioration? A. A healed childhood fracture aloneB. Stable spectacle useC. Infection or rapid arrhythmiaD. Normal sinus rhythm by itself

Question 06. A patient has pulmonary oedema and poor perfusion. What is appropriate? A. Unmonitored oral fluids until morningB. Routine discharge because swelling is commonC. Urgent senior assessment and monitored supportD. Ignoring perfusion because crepitations are present

Question 07. Why review NSAID use in worsening congestion? A. It always improves cardiac outputB. It confirms myocarditisC. It replaces echocardiographyD. It can promote sodium retention and kidney dysfunction

Question 08. What is a limitation of natriuretic peptide interpretation? A. Other conditions and obesity can affect levelsB. Levels always determine the exact valve lesionC. They directly measure ejection fractionD. They never vary with kidney function

Question 09. Which follow-up instruction is useful in chronic heart failure? A. Stop treatment whenever breathing improvesB. Avoid all future exercise permanentlyC. Ignore changes until the next annual visitD. Report worsening breathlessness, swelling or rapid weight change

Question 10. What should long-term therapy selection consider? A. Only the presence of ankle swellingB. Only the patient's occupationC. The same doses for every adultD. Heart-failure phenotype, pressure, kidney function and potassium

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References & Further Reading

Read the relevant guideline sections alongside these original clinical teaching cases. Local pathways, available services and individual patient factors determine care.

Reference review: 27 September 2026. Consult current local protocols for prescribing, procedures and escalation.