A 60-year-old male presents to his primary care provider reporting chest pain. He is diagnosed with atherosclerosis. This disease results in:

Choice A reason: Vasodilators are not the preferred agents for the initial treatment of heart failure. They are used as adjunctive therapy to reduce the afterload and preload on the heart. However, they do not address the fluid overload that is the main cause of heart failure symptoms.

Choice B reason: Diuretics are the preferred agents for the initial treatment of heart failure. They help to reduce the fluid overload and congestion in the lungs and peripheral tissues. They also lower the blood pressure and improve the cardiac output and renal function.

Choice C reason: Calcium channel blockers are not the preferred agents for the initial treatment of heart failure. They are contraindicated in most cases of heart failure because they can worsen the cardiac function and increase the mortality. They can also cause peripheral edema and hypotension.

Choice D reason: Direct renin inhibitors are not the preferred agents for the initial treatment of heart failure. They are a newer class of drugs that block the renin-angiotensin-aldosterone system (RAAS), which is involved in the pathophysiology of heart failure. However, they have not shown any significant benefit over the existing RAAS inhibitors, such as angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs). They can also cause hyperkalemia and renal impairment.

Choice A reason: Infection in the blood is not empyema. It is sepsis, which is a life-threatening condition that occurs when the body's response to infection causes tissue damage, organ failure, or death.

Choice B reason: Infection in the pleural space is empyema. It is a collection of pus in the space between the lungs and the chest wall, usually caused by a bacterial infection that spreads from the lungs or the chest cavity.

Choice C reason: Exudative bronchitis is not empyema. It is a type of bronchitis that involves inflammation and excess mucus production in the bronchi, the airways that carry air to the lungs.

Choice D reason: Infection localized in the lung is not empyema. It is pneumonia, which is an inflammation of the lung tissue, usually caused by a viral or bacterial infection that affects the air sacs or the interstitial tissue.