Pharm - Exam 3 - Antihyperlipidemics

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Pharmacology Quizzes & Trivia

Covers the antihyperlipidemics powerpoint for Pharmacology Exam #3.


Questions and Answers
  • 1. 
    • A. 

      They serve to transport lipids from tissue to tissue and participate in lipid metabolism.

    • B. 

      The inside of the particles has varying amounts of neutral lipids, cholesterol esters, and triacylglycerols.

    • C. 

      There are 5 major classes that have specific physiological and anatomical significance. The classes are chylomicrons, VLDL, IDL, LDL, and HDL.

    • D. 

      All of the above are true concerning lipoproteins.

  • 2. 
    Which type of lipoprotein is the largest particle of low density, and who's main function is to transport dietary lipids to tissues for use and storage?
    • A. 

      LDLs

    • B. 

      HDLs

    • C. 

      Chylomicrons

    • D. 

      IDLs

    • E. 

      VLDLs

  • 3. 
    Which apolipoprotein components of chylomicrons stimulate lipase?
    • A. 

      CII and E

    • B. 

      AI and AII

    • C. 

      B-48 and E

    • D. 

      CIII and AIV

  • 4. 
    • A. 

      VLDLs

    • B. 

      LDLs

    • C. 

      HDLs

    • D. 

      Chylomicrons

    • E. 

      IDLs

  • 5. 
    Which apolipoprotein is the major one in LDLs?
    • A. 

      CII

    • B. 

      B-100

    • C. 

      CIII

  • 6. 
    • A. 

      Chylomicrons

    • B. 

      IDLs

    • C. 

      HDLs

    • D. 

      LDLs

    • E. 

      VLDLs

  • 7. 
    What are high levels of VLDL (triglycerides >1000mg/dl) indicative of?
    • A. 

      A risk for heart disease.

    • B. 

      A risk for pancreatitis.

    • C. 

      A risk for stroke.

    • D. 

      A risk for gout.

  • 8. 
    Which lipoprotein is fromed from the LPL hydrolysis of triglycerides from VLDL? It is either taken up by the liver via LDL receptors or converted to LDL lipoproteins and its main function is as an intermediate for the synthesis of LDL.
    • A. 

      HDLs

    • B. 

      VLDLs

    • C. 

      LDLs

    • D. 

      IDLs

    • E. 

      Chylomicrons

  • 9. 
    Which lipoprotein is synthesized in the liver and intestine and is the smallest lipoprotein?
    • A. 

      IDLs

    • B. 

      VLDLs

    • C. 

      HDLs

    • D. 

      Chylomicrons

    • E. 

      LDLs

  • 10. 
    Which lipoprotein is considered a scavenger for cholesterol?
    • A. 

      HDLs

    • B. 

      LDLs

    • C. 

      VLDLS

    • D. 

      Chylomicrons

    • E. 

      IDLs

  • 11. 
    Which apolipoprotein is important in HDLs?
    • A. 

      AIV

    • B. 

      B-100

    • C. 

      CII

    • D. 

      E

    • E. 

      AI

  • 12. 
    What is the function of LCAT (lecithin cholesterol acyl transferase) and where is it located?
    • A. 

      Transfer of cholesteryl esters from HDL to LDL and VLDL - Plasma

    • B. 

      Hydrolysis of triglycerides in HDL and IDL - Liver

    • C. 

      Esterification of free cholesterol to cholesteryl esters - Plasma

    • D. 

      Hydrolysis of chylomicrons and VLDL triglycerides - Capillary Endothelium

  • 13. 
    What is the function and location of CETP (cholesterol ester transport protein)?
    • A. 

      Transfer of cholesteryl esters from HDL to LDL and VLDL - Plasma

    • B. 

      Hydrolysis of triglycerides in HDL and IDL - Liver

    • C. 

      Esterification of free cholesterol to cholesteryl esters - Plasma

    • D. 

      Hydrolysis of chylomicrons and VLDL triglycerides - Capillary Endothelium

  • 14. 
    What is the function and location of lipoprotein lipase?
    • A. 

      Transfer of cholesteryl esters from HDL to LDL and VLDL - Plasma

    • B. 

      Hydrolysis of triglycerides in HDL and IDL - Liver

    • C. 

      Esterification of free cholesterol to cholesteryl esters - Plasma

    • D. 

      Hydrolysis of chylomicrons and VLDL triglycerides - Capillary Endothelium

  • 15. 
    What is the function and location of hepatic lipase?
    • A. 

      Transfer of cholesteryl esters from HDL to LDL and VLDL - Plasma

    • B. 

      Hydrolysis of triglycerides in HDL and IDL - Liver

    • C. 

      Esterification of free cholesterol to cholesteryl esters - Plasma

    • D. 

      Hydrolysis of chylomicrons and VLDL triglycerides - Capillary Endothelium

  • 16. 
    • A. 

      Transport of LDLs from the arterial lumen into endothelial cells and into the space that underlies the arterial epithelium.

    • B. 

      An injury to the artery.

    • C. 

      Low potassium levels in the blood.

    • D. 

      A and B

    • E. 

      A, B, and C

    • F. 

      A and C

  • 17. 
    What do oxidized LDLs do?
    • A. 

      Attract monocytes from the cirulation in the sub-endothelial space, after which the monocytes undergo conversion to macrophages.

    • B. 

      Inhibit macrophage mobility, thereby keeping macrophages at the site of atherogenesis which generates free radicals to further oxidize the attached LDLs.

    • C. 

      Undergo uptake by macrophages.

    • D. 

      Are cytotoxic and hence can damage the endothelium directly.

    • E. 

      All of the above are correct.

  • 18. 
    What type of cells to macrophages become as they engulf more and more cholesterol, becoming large and vacuolated?
    • A. 

      Plasma Cells.

    • B. 

      Neutrophils.

    • C. 

      Xanthoma Cells.

    • D. 

      Super macrophages.

    • E. 

      Foam Cells.

    • F. 

      C and E.

  • 19. 
    Which drug to treat hyperlipidemia acts by inhibiting the mobilization of free fatty acids (FFA) from peripheral adipose tissue to the liver?
    • A. 

      Statins

    • B. 

      Fibric Acids

    • C. 

      Niacin (Nicotinic Acid)

    • D. 

      Bile acid-binding Resins

    • E. 

      Ezetimibe

  • 20. 
    • A. 

      Niacin

    • B. 

      Bile acid-binding resins

    • C. 

      Ezetimibe

    • D. 

      Statins

    • E. 

      Fibric Acids

  • 21. 
    What is the drug of choice for lowering VLDL levels in patients at risk of pancreatitis and for mixed elevations of LDLs and VLDLs and low levels of HDLs?
    • A. 

      Fibric Acids

    • B. 

      Ezetimibe

    • C. 

      Statins

    • D. 

      Niacin

    • E. 

      Bile acid-binding resins

  • 22. 
    • A. 

      By taking an NSAID like Aspirin concurrently.

    • B. 

      By taking the medication at night.

    • C. 

      By taking the medication with food.

    • D. 

      By taking the medication on an empty stomach.

    • E. 

      The adverse effects cannot be avoided.

  • 23. 
    • A. 

      Gout

    • B. 

      Cardiac atrial arrhythmias

    • C. 

      Diabetes

    • D. 

      Gallbladder disease

    • E. 

      All of the above

  • 24. 
    Giving Niacin in combination with statins causes an increased risk of what disease?
    • A. 

      Gout.

    • B. 

      MI.

    • C. 

      Renal disease.

    • D. 

      Myopathy (rhabdomyolysis).

    • E. 

      Hepatic failure.

  • 25. 
    What are the two drugs that are classified as fibric acid derivatives?
    • A. 

      Niacin and Gemfibrozil.

    • B. 

      Gemfibrozil and Fenofibrate.

    • C. 

      Fenofibrate and Ezetimibie.

    • D. 

      Simvastatin and Gemfibrozil.

  • 26. 
    • A. 

      Enhance oxidation of FA in liver and muscle.

    • B. 

      Reduce rate of lipogenesis in the liver.

    • C. 

      Increase synthesis of Apo AI and II for more HDL.

    • D. 

      All of the above.

  • 27. 
    What is the principle indication for all fibrates?
    • A. 

      Elevation of LDLs.

    • B. 

      Reduction of HDLs.

    • C. 

      Elevation of VLDLs.

    • D. 

      High blood cholesterol levels.

    • E. 

      High blood pressure.

  • 28. 
    Which drug can be displaced by the fibrates, causing increased levels of the drug in the blood?
    • A. 

      Aspirin

    • B. 

      Tetracycline

    • C. 

      Warfarin

    • D. 

      Ezetimibe.

    • E. 

      Vicodin.

  • 29. 
    How do the Bile Acid-Binding Resins (Cholestyramine, Colestipol, and Colesevelam) function?
    • A. 

      By binding LDLs and removing them from circulation.

    • B. 

      By increasing HDLs.

    • C. 

      By attacking the plaque directly.

    • D. 

      By cationic exchange.

    • E. 

      By anionic exchange.

  • 30. 
    Does the binding of bile acids by bile acid-binding resins cause an increase in plasma LDL levels or a decrease?
    • A. 

      Increase.

    • B. 

      Decrease.

  • 31. 
    What type of individual would not benefit as much from the bile acid-binding resins?
    • A. 

      Hemophiliacs.

    • B. 

      Patients suffering from gout.

    • C. 

      Patients genetically deficient in LDL receptors.

    • D. 

      Patients with a fever.

    • E. 

      Patients in renal failure.

  • 32. 
    If a patient is at risk for pancreatitis, which drugs would you want to avoid?
    • A. 

      Fibric acid derivatives

    • B. 

      Bile Acid-Binding Resins

    • C. 

      Niacin

    • D. 

      Statins

    • E. 

      Ezetimibe

  • 33. 
    Which are the most effective antihyperlipidemics with few side effects?
    • A. 

      Niacin

    • B. 

      FIbric Acids

    • C. 

      Bile acid-binding resins

    • D. 

      Ezetimibe

    • E. 

      Statins

  • 34. 
    Which drugs are competitive inhibitors of hepatic HMG CoA reductase, the rate-limiting enzyme in cholesterol biosynthesis?
    • A. 

      Statins

    • B. 

      Ezetimibe

    • C. 

      Fibric Acids

    • D. 

      Bile acid-binding resins

    • E. 

      Niacin

  • 35. 
    • A. 

      With less cholesterol synthesized, the amount of cholesterol in the liver is reduced.

    • B. 

      Serum cholesterol level is reduced due to the fact that more LDL receptors are synthesized and more LDL is removed from the blood.

    • C. 

      VLDL and IDL might also be removed because their ApoE component is recognized by LDL receptors.

    • D. 

      Reduction of inflammation by an unknown mechanism.

    • E. 

      All of the above.

  • 36. 
    Which statins are inactive lactone prodrugs that must be hydrolyzed to the active beta-hydroxyl derivatives?
    • A. 

      Atovastatin and Fluvastatin

    • B. 

      Lovastatin and Simvastatin

    • C. 

      Pravastatin and Simvastatin

    • D. 

      Fluvastatin and Pravastatin

    • E. 

      Rosuvastatin and Simvastatin

  • 37. 
    • A. 

      Rosuvastatin and simvastatin

    • B. 

      Simvastatin and fluvastatin

    • C. 

      Rosuvastatin and lovastatin

    • D. 

      Pravastatin and lovastatin

  • 38. 
    Which statins have a high first pass extraction by the liver?
    • A. 

      Rosuvastatin and fluvastatin

    • B. 

      Simvastatin and rosuvastatin

    • C. 

      Lovastatin and simvastatin

    • D. 

      Atorvastatin and fluvastatin

  • 39. 
    The drugs azole-antifungal, erythromicin, clarithromycin, cyclosporine, calcium channel blockers (verapamil and diltiazem), ritonavir or grapefruit juice - which all inhibit cytochrome P450 enzymes - CYP3A4 can all inhibit the metabolism of which statins?
    • A. 

      Simvastatin and rosuvastatin

    • B. 

      Lovastatin, rosuvastatin, and atorvastatin

    • C. 

      Atovastatin, simvastatin, and lovastatin

    • D. 

      Rosuvastatin, lovastatin, and simvastatin

  • 40. 
    Which drug accelerates the metabolism of statins?
    • A. 

      Erythromycin

    • B. 

      Cyclosporine

    • C. 

      Rifampin

    • D. 

      Vitamin K

    • E. 

      Warfarin

  • 41. 
    Which statin is metabolized by CYP2C9 and has fewer drug interactions?
    • A. 

      Atorvastatin

    • B. 

      Lovastatin

    • C. 

      Pravastatin

    • D. 

      Fluvastatin

    • E. 

      Simvastatin

  • 42. 
    Which statins are not (significantly) metabolized by the cytochrome system and would not be affected by inducers or inhibitors of the cytochrome P450 system?
    • A. 

      Fluvastatin and simvastatin

    • B. 

      Pravastatin and rosuvastatin

    • C. 

      Rosuvastatin and atorvastatin

    • D. 

      Lovastatin and pravastatin

  • 43. 
    Which statin reaches higher plasma levels in Asian patients and should possibly be given in lower doses to these patients?
    • A. 

      Atorvastatin

    • B. 

      Lovastatin

    • C. 

      Pravastatin

    • D. 

      Fluvastatin

    • E. 

      Simvastatin

    • F. 

      Rosuvastatin

  • 44. 
    Why are most statin drugs given at night?
    • A. 

      To decrease stomach upset.

    • B. 

      Because cholesterol synthesis increases at night.

    • C. 

      To increase absorption.

    • D. 

      Because food intake decreases absorption.

  • 45. 
    Which statins have longer half-lives and so can be given at any time of day?
    • A. 

      Fluvastatin and rosuvastatin

    • B. 

      Simvastatin and atorvastatin

    • C. 

      Pravstatin and Lovastatin

    • D. 

      Rosuvastatin and atorvastatin

    • E. 

      Fluvastatin and simvastatin

  • 46. 
    Statins plus what other drug may lower the risk of colon cancer and osteoporosis?
    • A. 

      Aspirin

    • B. 

      Warfarin

    • C. 

      Heparin

    • D. 

      Ezetimibe

    • E. 

      Niacin

  • 47. 
    Myopathy is a possible adverse effect for all statins, but which statin plus gemfibrozil or niacin especially increases this risk?
    • A. 

      Atorvastatin

    • B. 

      Lovastatin

    • C. 

      Pravastatin

    • D. 

      Fluvastatin

    • E. 

      Simvastatin

  • 48. 
    Are statins ok to give during pregnancy?
    • A. 

      Yes

    • B. 

      No

  • 49. 
    Which statins would  you want to give a renally compromised patient?
    • A. 

      Fluvastatin and Lovastatin

    • B. 

      Pravastatin and Rosuvastatin

    • C. 

      Atorvastatin and Fluvastatin

    • D. 

      Rosuvastatin and Atorvastatin

    • E. 

      Simvastatin and Pravstatin

  • 50. 
    Which statins could cause vivid dreams or fuzzy thinking?
    • A. 

      Atorvastatin and Pravastatin

    • B. 

      Simvastatin and Fluvastatin

    • C. 

      Simvastatin and Lovastatin

    • D. 

      Rosuvastatin and Atorvastatin

    • E. 

      Fluvastatin and Pravastatin

  • 51. 
    How does Ezetimibe act as an antihyperlipidemic?
    • A. 

      Inhibits intestinal absorption of cholesterol at the brush border of the small intestine.

    • B. 

      Inhibits absorption of cholesterol at the lining of the stomach.

    • C. 

      Inhibits absorption of cholesterol at the brush border of the larger intestine.

    • D. 

      Binds cholesterol and excretes it in the urine.

  • 52. 
    • A. 

      Niacin

    • B. 

      Statins

    • C. 

      Fibric acids

    • D. 

      Bile acid-binding resins

    • E. 

      Ezetimibe

  • 53. 
    Which antihyperlipidemics interfere with absorption of ezetimibe and so must be taken separately?
    • A. 

      Atorvastatin and simvastatin

    • B. 

      Fibric acids

    • C. 

      Niacin

    • D. 

      Cholestyramineand colestipol

    • E. 

      Fluvastatin and rosuvastatin