Deck 41: Hyperlipidemia

Question 1

Sharlene is a 65-year-old patient who has been on a lipid-lowering diet and using plant sterol margarine daily for the past three months. Her LDL is 135 mg/dL. An appropriate treatment for her would be:

A)A statin
B)Niacin
C)A fibric acid derivative
D)Determined by her risk factors

Answer 1

Determined by her risk factors

Question 2

The most recent treatment guidelines strongly recommend dosing primarily based on:

A)Family history
B)Personal CV risk
C)Specific lipid levels
D)Twenty-year risk of CV event

Answer 2

Personal CV risk

Question 3

Joanne is a 60-year-old patient with an LDL of 132 and a family history of coronary artery disease. She has already tried diet changes (increasing fiber and plant sterols) to lower her LDL but after six months her LDL is slightly higher. The next step in her treatment would be:

A)A statin
B)Niacin
C)Sterols
D)A fibric acid derivative

Answer 3

A statin

Question 4

Monitoring of a patient who is on a lipid-lowering drug includes:

A)Fasting total cholesterol every six months
B)Lipid profile with attention to serum LDL 6 to 8 weeks after starting therapy, then again in six weeks
C)Complete blood count, C-reactive protein, and erythrocyte sedimentation rate after six weeks of therapy
D)All of the above

Question 5

Jamie is a 34-year-old pregnant woman with familial hyperlipidemia and elevated LDL levels. What is the appropriate treatment for a pregnant woman?

A)A statin
B)Niacin
C)Fibric acid derivative
D)Bile acid-binding resins

Question 6

What is considered the order of statin strength from lowest effect to highest?

A)Lovastatin, Simvastatin, Rosuvastatin
B)Rosuvastatin, Lovastatin, Atorvastatin
C)Atorvastatin, Rosuvastatin, Simvastatin
D)Simvastatin, Atorvastatin, Lovastatin

Question 7

Which statins are most associated with soft plaque regression?

A)Lovastatin and simvastatin
B)Rosuvastatin and atorvastatin
C)Atorvastatin and pravastatin
D)Lovastatin and rosuvastatin

Question 8

Omega-3 fatty acids are best used to help treat:

A)High HDL
B)Low LDL
C)High triglycerides
D)Any high lipid value

Question 9

When are statins traditionally ordered to be taken?

A)At bedtime
B)At noon
C)At breakfast
D)With the evening meal

Question 10

Fiber supplements are great options for elderly patients who have the concurrent problem of:

A)End-stage renal failure on fluid restriction
B)Recurrent episodes of diarrhea several times a day
C)Long-term issues of constipation
D)Needing to take multiple medications around the clock every two hours

Question 11

Han is a 48-year-old diabetic with hyperlipidemia and high triglycerides. His LDL is 112 mg/dL and he has not tolerated statins. He warrants a trial of a:

A)Sterol
B)Niacin
C)Fibric acid derivative
D)Bile acid-binding resin

Question 12

The overall goal of treating hyperlipidemia is:

A)Maintain a low-density lipoprotein (LDL) level of less than 160 mg/dL
B)To reduce atherogenesis
C)Lowering apo-B, one of the apolipoproteins
D)All of the above

Question 13

When considering which cholesterol-lowering drug to prescribe, which factor determines the type and intensity of treatment?

A)Total LDL
B)Fasting high-density lipoprotein (HDL)
C)Coronary artery disease risk level
D)Fasting total cholesterol

Question 14

When starting a patient on a statin, education would include:

A)If they stop the medication their lipid levels will return to pretreatment levels.
B)Medication is a supplement to diet therapy and exercise.
C)If they have any muscle aches or pain, they should contact their provider.
D)All of the above

Question 15

Phil is a 54-year-old male with multiple risk factors who has been on a high-dose statin for three months to treat his high LDL level. His LDL is still higher than his goal and his triglycerides are elevated. A reasonable change in therapy would be to:

A)Discontinue the statin and change to a fibric acid derivative.
B)Discontinue the statin and change to ezetimibe.
C)Continue the statin and add in ezetimibe.
D)Refer him to a specialist in managing patients with recalcitrant hyperlipidemia.

Question 16

James is a 45-year-old patient with a very high cardiovascular (CV) risk profile, an LDL level of 120, and normal triglycerides. Appropriate first-line therapy for James may include diet counseling, increased physical activity, and:

A)A statin
B)Niacin
C)Sterols
D)A fibric acid derivative

Question 17

Before starting therapy with a statin, the following baseline laboratory values should be evaluated:

A)Complete blood count
B)Liver function [alanine aminotransferase/aspartate aminotransferase (ALT/AST)] and creatine kinase
C)C-reactive protein
D)All of the above

Question 18

First-line therapy for hyperlipidemia is:

A)Statins
B)Niacin
C)Lifestyle changes
D)Bile acid-binding resins

Question 19

Which of the following patients should not have a statin medication ordered?

A)Someone with three first- or second-degree family members with history of muscle issues when started on statins
B)Someone with high lipids but low body mass index (BMI)
C)Premenopausal woman who have had a recent hysterectomy
D)A prediabetic male with known metabolic syndrome

Question 20

Jose is a 12-year-old overweight child with a total cholesterol of 180 mg/dL and LDL of 125 mg/dL. Along with diet education and recommending increased physical activity, a treatment plan for Jose would include ____________ with a re-evaluation in six months.

A)Statins
B)Niacin
C)Sterols
D)Bile acid-binding resins

Question 21

Omega-3 supplements can come from animal or plant sources. Which of the following is correct?

A)Both sources have equal efficacy.
B)Plant sources have more rapid impact on LDL levels than fish sources.
C)Fish sources have potential contamination with mercury.
D)Marine creature-derived supplements are safe for patients with shellfish allergies.

Question 22

Why has nonfasting lipid testing become popular?

A) Results are close enough to fasting results and help in observing trends of the therapeutic response.
B) Screening helps identify larger numbers of patients who should be treated.
C) More patients tend to keep lab appointments when fasting is not required.
D) All of the above

Question 23

The first step in responding to a patient who complains of muscular pain with statins is:

A)Review the history and characteristics of the pain.
B)Stop the medication and draw liver function tests.
C)Switch them to another statin.
D)Draw a lipid level to determine if dosing is still indicated.