1.
Directions: questions 1-4
Match each antihyperlipidemic drug with the appropriate description (each lettered option can be
selected once, more than once, or not at all):
This drug can sometimes cause hypertriglyceridemia
A. 
B. 
C. 
D. 
E. 
2.
Directions: questions 1-4
Match each antihyperlipidemic drug with the appropriate description (each lettered option can be
selected once, more than once, or not at all):
Facial flushing is the most common adverse effect of this drug
A. 
B. 
C. 
D. 
E. 
3.
Directions: questions 1-4
Match each antihyperlipidemic drug with the appropriate description (each lettered option can be
selected once, more than once, or not at all):
High doses of this drug can cause metabolic acidosis
A. 
B. 
C. 
D. 
E. 
4.
Directions: questions 1-4
Match each antihyperlipidemic drug with the appropriate description (each lettered option can be
selected once, more than once, or not at all):
This drug activates a nuclear transcription receptor
A. 
B. 
C. 
D. 
E. 
5.
A 21-year-old woman recently diagnosed with familial combined hyperlipidemia,
started a treatment with lovastatin. Which of the following molecular actions most likely
mediated the therapeutic efficacy of the drug in the patient’s disease?
A. 
Down-regulation of hepatic LDL receptors
B. 
Increased synthesis of lipoprotein lipase
C. 
Decreased synthesis of mevalonic acid
D. 
Decreased storage of LDL in hepatic endosomes
E. 
Increased plasma levels of hepatic aminotransferases
F. 
Increased plasma levels of creatine phosphokinase
6.
A 28-year-old woman, recently diagnosed with familial combined hyperlipidemia,
started a treatment with a low fat diet and cholestyramine. The therapy most likely
caused the highest reduction of plasma levels of which of the following compounds?
A. 
B. 
C. 
D. 
E. 
7.
A 54-year-old obese man had a plasma LDL cholesterol of 270 mg/dL in spite of 4
month therapy with lovastatin. The physician decided to add cholestyramine to the
patient’s regimen. Recently the patient was found to have a stage I hypertension and he
was currently taking propranolol and hydrochlorothiazide. Which of the following
changes in the pharmacokinetics of these two drugs most likely occurred because of
cholestyramine administration?
A. 
Renal elimination of propranolol increased
B. 
Renal elimination of hydrochlorothiazide decreased
C. 
Oral bioavailability of propranolol increased
D. 
Oral bioavailability of hydrochlorothiazide decreased
E. 
Volume of distribution of propranolol increased
F. 
Volume of distribution of hydrochlorothiazide decreased
8.
A 52-year-old man was found to have a total cholesterol of 380 mg/dL and
triglycerides of 230 mg/dL in spite of three months of low saturated fat diet. The man had
been suffering from hemophilia since birth and from external hemorrhoids for two years.
An antihyperlipidemic therapy was prescribed. Which of the following drugs would be
contraindicated in this patient?
A. 
B. 
C. 
D. 
E. 
9.
A 24-year-old woman suffering from familial hypertriglyceridemia was screened with a
blood profile during a follow-up visit. Relevant laboratory test results were: uric acid 15
mg/dL (normal 4-8.5), total cholesterol 170 mg/dL (normal < 200), triglycerides 1230
mg/dL (normal < 200). A lipid-lowering drug was prescribed. Which of the following was
most likely the mechanism of action of that drug?
A. 
Decrease of lipid synthesis on adipose tissue
B. 
Down-regulation of LDL receptors in the liver
C. 
Inhibition HMG-CoA reductase activity in the liver
D. 
Stimulation of lipoprotein lipase synthesis
E. 
Decreased absorption of exogenous cholesterol
10.
A 55-year-old obese woman was found to have a cholesterol level of 360 mg/dL
despite many months of lovastatin treatment. The physician decided to add ezetimibe to
the therapeutic regimen. Which of the following cells represents the main site of action
of the added drug?
A. 
B. 
Capillary endothelial cells
C. 
D. 
E. 
Intestinal epithelial cells
11.
A 57-year-old man was found to have a LDL-cholesterol of 360 mg/dL in spite of 5
months of treatment with lovastatin. The physician decided to add ezetimibe to the
therapeutic regimen. Which of the following statements best explain the rationale of
adding this drug to lovastatin therapy?
A. 
The combination decreases the risk of lovastatin-induced myopathy
B. 
The combination results in synergistic cholesterol-lowering effects
C. 
Ezetimibe slows down the metabolism of lovastatin
D. 
Ezetimibe increases the intestinal absorption of lovastatin
E. 
The combination strongly increases HDL plasma levels
12.
A 46-year-old man, suffering from familial hypercholesterolemia, was found to have a
total cholesterol of 430 mg/dL in spite of many months of treatment with lovastatin.
Triglyceride levels were normal. The physician decided to add niacin to the therapeutic
regimen. Which of the following molecular action most likely mediated the therapeutic
efficacy of the drug in the patient’s disease?
A. 
Inhibition of VLDL production by the hepatocyte
B. 
Inhibition of HDL synthesis by the liver
C. 
Increase of circulating fibrinogen
D. 
Stimulation of lipolysis in adipose tissue
E. 
Decreased absorption of exogenous cholesterol
13.
A 47-year-old man was brought by ambulance to the coronary unit with the admitting
diagnosis of myocardial infarction. An emergency therapy was started which included
alteplase, aspirin, heparin, and metoprolol. The next day lovastatin and ezetimibe were
added to the therapeutic regimen. Which of the drugs received by the patient acts mainly
on liver cell cytosol?
A. 
B. 
C. 
D. 
E. 
F. 
14.
A 52-year-old obese man suffering from gout and hypertension was found to have
LDL cholesterol of 360 mg/dL and a serum uric acid of 15.5 mg/dL during a follow-up
visit. Other laboratory values were within normal limits. A lipid-lowering therapy is
prescribed. Which of the following antihyperlipidemic drugs would be relatively
contraindicated in this patient?
A. 
B. 
C. 
D. 
E. 
15.
A 56-year-old woman, suffering from familial hypercholesterolemia, was found to
have a total cholesterol of 470 mg/dL in spite of many months of treatment with
lovastatin. Triglyceride levels were normal. The physician decided to add niacin to the
therapeutic regimen. Which of the following drugs should be given during the first days
of therapy, to avoid niacin induced hot flushes?
A. 
B. 
C. 
D. 
E. 
16.
A 45-year-old obese man suffering from type I diabetes mellitus and hyperlipidemia
was admitted to the hospital because of vomiting and circulatory collapse. The patient
had started an antihyperlipidemic therapy one month ago. Pertinent plasma data on
admission were: pH 7.32, HCO3 12 mEq/L (normal 22-26), PaCO2 16 mm Hg (normal 25-
45), Cl 125 mEq/L (normal 90-105). Which of the following drugs could have contributed
to the syndrome the patient was suffering from?
A. 
B. 
C. 
D. 
E. 
17.
A 57-year-old woman was found to have triglyceride levels of 630 mg/dL during a
follow-up visit.. A therapy with gemfibrozil was prescribed. Which of the following
cellular structures most likely represents the site of action of this drug?
A. 
Smooth endoplasmic reticulum
B. 
C. 
D. 
E. 
Rough endoplasmic reticulum
F. 
18.
A 45-year-old man complained to his physician of muscle aches, soreness and
weakness. The patient had been suffering from duodenal ulcer for 2 years, from familial
hypercholesterolemia for 5 years and from open angle glaucoma for one year. Present
therapy included famotidine and sucralfate for ulcer, lovastatin for hyperlipidemia and
timolol and latanoprost for glaucoma. An urinalysis showed myoglobinuria. Which of the
following drugs most likely caused this finding?
A. 
B. 
C. 
D. 
E. 
19.
A 49-year-old man was found to have the following lipid profile during a routine visit:
LDL cholesterol 180 mg/dL (normal < 200), HDL cholesterol 14 mg/dL (normal > 35),
triglycerides 150 mg/dL (normal < 200). The man weighted 134 Kg and was a heavy
cigarette-smoker. Which of the following antihyperlipidemic drugs would be most
appropriate for this patient?
A. 
B. 
C. 
D. 
E. 
20.
A 26-year-old obese woman, who was found to have a LDL-cholesterol level of 270
mg/mL despite four months of diet, started a lipid-lowering therapy with cholestyramine.
Which of the following is the main site of action of action of this drug?
A. 
B. 
C. 
D. 
E. 
F.