skip to main content

Heart Failure Medicines Optimisation — UKMLA MCQ

Instant feedback + full explanation. One question, done properly.

HardCardiologyHeart Failure Medicines OptimisationUKMLAMRCP Part 1MRCGP AKT

A patient with HFrEF starts spironolactone after baseline potassium and renal function are satisfactory. The dose is unchanged and the patient is clinically stable. When should renal function and electrolytes first be rechecked?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Within 1–2 weeks of starting treatment

The best answer is “Within 1–2 weeks of starting treatment”. NICE requires early biochemical surveillance after starting an MRA because potassium and kidney function can change before symptoms develop. Testing is repeated 1–2 weeks after initiation and after each dose increment, then at longer intervals once the maximum tolerated dose is stable. Waiting 6 weeks or longer can miss clinically important hyperkalaemia or renal decline.

Reference: NICE NG106, Chronic heart failure in adults: https://www.nice.org.uk/guidance/ng106/chapter/Recommendations