Cardiovascular Drugs USMLE Step 1 Practice Question
A 56-year-old woman with a known history of heart failure with reduced ejection fraction (EF 28%) and hypertension presents to her cardiologist for a follow-up visit. She was initiated on carvedilol and lisinopril two weeks ago and has been maintained on optimal doses. Her blood pressure is 118/74 mmHg, heart rate is 68 bpm, and oxygen saturation is 94% on room air. Physical examination reveals jugular venous distension, bilateral basilar crackles, and 2+ pitting edema extending to the mid-calf. She reports waking up at night unable to breathe and requiring two pillows to sleep comfortably. A loop diuretic is added to her regimen for symptom management. Which of the following best describes the pharmacological role of the diuretic in this setting?
Answer choices
- ADiuretics reduce mortality in heart failure by preventing sudden cardiac death arrhythmias
- BDiuretics reverse left ventricular remodeling by reducing chamber afterload
- CDiuretics activate neurohormonal compensation mechanisms that improve cardiac function
- DDiuretics provide symptomatic relief of congestion but do not alter the underlying disease progression or prognosisCorrect answer
- EDiuretics improve myocardial contractility through reduced preload optimization
- FDiuretics reduce pulmonary edema by inhibiting aldosterone and decreasing sympathetic nervous system activation
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