Heart Failure USMLE Step 1 Practice Question
A 34 year old woman develops fatigue, dyspnea on exertion, and bounding peripheral pulses several months after creation of a large arteriovenous fistula for hemodialysis access. Skin is warm and blood pressure is 132/48 mm Hg. Cardiac output is increased on hemodynamic testing. Which of the following best explains her symptoms?
Answer choices
- AIncreased systemic vascular resistance causing pressure overload
- BObstruction of left ventricular outflow tract
- CReduced venous return due to preload depletion
- DHigh output state from decreased systemic vascular resistanceCorrect answer
- EFixed reduction in diastolic filling due to pericardial scarring
- FRestrictive cardiomyopathy from dialysis-related amyloidosis
See the full explanation
Get the correct-answer rationale, why each distractor is wrong, the underlying mechanism, and high-yield associations — plus adaptive practice that targets your weak areas — with a free MedBoardPRO account.