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Heart failure discharge follow-up — USMLE Step 3 MCQ

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ModerateInternal Medicine (chronic management)Heart failure discharge follow-upUSMLE Step 3

A 72-year-old man returns 1 week after hospitalization for heart failure with reduced ejection fraction. He is euvolemic, blood pressure is 118/70 mm Hg, potassium is 4.4 mEq/L, and estimated GFR is 58 mL/min/1.73 m2. He takes carvedilol and furosemide. Which of the following would you recommend at the follow-up visit?

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Correct answer: E — Initiate or titrate guideline-directed medical therapy including RAAS-neprilysin inhibition as tolerated

HFrEF follow-up should include initiation and titration of guideline-directed therapy such as ARNI/ACEI/ARB, beta blocker, MRA, and SGLT2 inhibitor as tolerated.

Reference: ACC/AHA/HFSA heart failure guideline