Question 1

When using the 2013 ACC/AHA &#34;Guideline on the Assessment of Cardiovascular Risk&#34; to treat patients with hyperlipidemia, the practitioner understands that it will provide what information?&#10;A) Goals for treatment for low-density lipoprotein levels&#10;B) How to titrate statin drugs to achieve goal levels&#10;C) Use of non-statin therapy for primary prevention&#10;D) Which patients will benefit from statin therapy

Accepted Answer

The 2013 ACC/AHA guidelines on the assessment of cardiovascular risk primarily focus on identifying patients who would benefit from statin therapy based on their overall risk of cardiovascular disease, rather than targeting specific LDL cholesterol levels or providing specific guidance on titrating statin drugs or using non-statin therapy for primary prevention.

Question 2

A patient with type 2 diabetes has a low-density lipoprotein (LDL) level of 110 gm/dL. What is recommended to manage this patient?&#10;A) Dietary and lifestyle changes to modify risk&#10;B) Initial treatment with a low intensity statin medication&#10;C) Prescription of a moderate or high intensity statin&#10;D) Statin therapy until the LDL level is below 75 mg/dL

Accepted Answer

The American Diabetes Association recommends that individuals with type 2 diabetes and an LDL level of 70-189 mg/dL be prescribed a moderate or high intensity statin medication. Lifestyle changes can also be implemented, but medication is often needed to reach target LDL levels. Initial treatment with a low intensity statin medication (choice B) may not be sufficient to lower LDL to target levels. Statin therapy until the LDL level is below 75 mg/dL (choice D) may be too aggressive and unnecessary, as the target LDL level for individuals with diabetes is usually below 100 mg/dL.

Question 3

A patient who is taking a statin drug to treat dyslipidemia has begun a diet and exercise program. The patient reports new onset of muscle pain several weeks after beginning therapy. What is the initial action by the provider?

A) Discontinue the statin drug immediately
B) Obtain a creatine kinase level
C) Prescribe acetaminophen or ibuprofen
D) Recommend reducing exercise intensity

B

Accepted Answer

The patient's new onset of muscle pain may indicate myopathy, a potential side effect of statin therapy. Obtaining a creatine kinase level can help confirm the diagnosis and assess the severity of the muscle damage. Depending on the creatine kinase level, the provider may consider discontinuing the statin drug, reducing the dose, or changing to a different lipid-lowering agent. Prescribing acetaminophen or ibuprofen may provide symptomatic relief but will not address the underlying issue of myopathy. Recommending reducing exercise intensity is not necessary without further investigation and may interfere with the patient's health goals.

Deck 191: Lipid Disorders