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:

Accepted Answer

A fibric acid derivative is an appropriate treatment for Sharlene because she has been on a lipid-lowering diet and using plant sterol margarine daily for the past three months, and her LDL is still 135 mg/dL.

Question 2

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

Accepted Answer

B

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:

Accepted Answer

Statins are the first-line pharmacological treatment for high LDL cholesterol, especially in patients with a family history of coronary artery disease and when lifestyle modifications (such as diet changes) have failed to lower LDL levels effectively.

Question 4

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

Accepted Answer

Monitoring a patient on a lipid-lowering drug typically involves checking the lipid profile, with particular attention to serum LDL levels, after starting therapy and then periodically to assess the drug's effectiveness and adjust treatment as necessary. Choices A and C are not standard monitoring practices specifically for lipid-lowering therapy.

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?

Accepted Answer

Bile acid-binding resins are considered safe for use during pregnancy to manage elevated LDL levels, as they are not absorbed systemically and therefore do not pose a risk to the fetus. Statins, niacin, and fibric acid derivatives are generally avoided during pregnancy due to potential adverse effects on the fetus.

Question 6

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

Accepted Answer

The correct order from lowest to highest statin strength is Lovastatin, Simvastatin, Rosuvastatin. Lovastatin is considered a weaker statin, Simvastatin has a moderate effect, and Rosuvastatin is one of the strongest statins available.

Question 7

Which statins are most associated with soft plaque regression?

Accepted Answer

Rosuvastatin and atorvastatin are the statins most associated with soft plaque regression. They are both high-intensity statins that have been shown in studies to effectively reduce LDL cholesterol levels and have a significant impact on plaque stabilization and regression.

Question 8

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

Accepted Answer

Omega-3 fatty acids are best known for their effectiveness in lowering high triglycerides, which are a type of fat found in the blood.

Question 9

When are statins traditionally ordered to be taken?

Accepted Answer

The answer of When are statins traditionally ordered to be...

Question 10

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

Accepted Answer

Fiber supplements are primarily used to improve bowel regularity and alleviate constipation, making them suitable for individuals with long-term issues of constipation, including elderly patients. They are not specifically recommended for conditions like end-stage renal failure on fluid restriction, recurrent diarrhea, or the need to take multiple medications frequently, as these conditions require different management approaches.

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:

Accepted Answer

Fibric acid derivatives are effective in lowering triglycerides, which is a concern for Han. Since he cannot tolerate statins, a fibric acid derivative is a suitable alternative for managing his lipid profile.

Question 12

The overall goal of treating hyperlipidemia is:

Accepted Answer

The primary goal of treating hyperlipidemia is to reduce atherogenesis, which is the formation of fatty deposits in the arteries, thereby reducing the risk of cardiovascular diseases.

Question 13

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

Accepted Answer

The type and intensity of cholesterol-lowering treatment are primarily determined by the patient's overall risk of coronary artery disease (CAD), rather than just their cholesterol levels. This approach allows for a more personalized treatment plan that considers the patient's specific risk factors and the potential benefits of reducing their cardiovascular risk.

Question 14

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

Accepted Answer

Statins are a class of drugs used to lower cholesterol levels in the blood, which helps prevent heart disease and stroke. When starting a patient on a statin, it's important to educate them on several key points: A) If they stop taking the medication, their lipid levels are likely to return to pretreatment levels, negating the benefits of the medication. B) Statins should be used in conjunction with diet and exercise for the best outcomes, not as a sole treatment. C) Muscle aches or pain can be a side effect of statins, and patients should report these symptoms to their healthcare provider as they may indicate a need to adjust the medication. Therefore, all of the statements are correct and important parts of patient education when starting statin therapy.

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:

Accepted Answer

Ezetimibe is a non-statin lipid-lowering agent that can be added to a statin to further lower LDL and triglycerides.

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:

Accepted Answer

Statins are the first-line therapy for patients with a high cardiovascular risk profile and elevated LDL levels, as they effectively lower LDL cholesterol and reduce cardiovascular events.

Question 17

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

Accepted Answer

Liver function tests (ALT/AST) and creatine kinase are important baseline laboratory values to evaluate before starting therapy with a statin, as statins can affect liver function and muscle tissue.

Question 18

First-line therapy for hyperlipidemia is:

Accepted Answer

Lifestyle changes, including diet and exercise, are considered the first-line therapy for managing hyperlipidemia before initiating medication.

Question 19

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

Accepted Answer

Patients with a family history of muscle issues related to statin use may have a genetic predisposition to similar adverse effects, making it prudent to avoid prescribing statins to these individuals.

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.

Accepted Answer

Sterols are recommended for children with elevated LDL cholesterol levels as part of a dietary approach to lower cholesterol. They can help block the absorption of cholesterol from the diet. Statins, niacin, and bile acid-binding resins are generally considered more aggressive treatments and are typically not first-line treatments for children unless specifically indicated by a healthcare provider based on individual risk factors and conditions.

Quiz 41: Hyperlipidemia