Pharmacotherapy - Dyslipidemias
- 1.
Which of the following are risk factors for coronary heart disease? Select all that apply.
- A.
Male greater or equal to 55, female greater than or equal to 65.
- B.
Family history of premature CHD events (male first degree relative
- C.
Hypertension (SBP greater than or equal to 140, DBP greater than or equal to 90)
- D.
HDL (less than 40mg/dL)
- E.
Cigarette smoking within the past year
Correct Answer(s)
B. Family history of premature CHD events (male first degree relative
C. Hypertension (SBP greater than or equal to 140, DBP greater than or equal to 90)
D. HDL (less than 40mg/dL)Explanation
Male greater than or equa to 45, female greater than or equal to 55.
Cigarette smoking within the past MONTH.Rate this question:
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- 2.
Individuals with established CHD, other clinical atherosclerotic disease (CAD) have a greater than 20% risk over a 10-year period of developing CHD. The ATP III guidelines set the target LDL cholesterol level at less than 100mg/dL (optional: less than 70) for high risk patients who have a history of one or more of the following:Select all that apply.
- A.
MI or coronary interventions (bypass, PTCA, stents)
- B.
Unstable angina and chronic stable angina
- C.
PAD
- D.
Stroke/TIA
- E.
Diabetes
Correct Answer(s)
A. MI or coronary interventions (bypass, PTCA, stents)
B. Unstable angina and chronic stable angina
C. PAD
D. Stroke/TIA
E. Diabetes -
- 3.
A fasting lipid profile is preferred so an accurate assessment of LDL cholesterol can be performed, and fasting will allow the clearance of triglycerides carried by ______________ from the circulation, allowing VLDL cholesterol to be determined.
- A.
LDL
- B.
Micelles
- C.
Chylomicrons
- D.
Foam cells
- E.
Macrophages
Correct Answer
C. Chylomicrons -
- 4.
If serum triglycerides are greater than _____ mg/dL, the estimated value LDL equation (LDL = total cholesterol - (HDL cholesterol + triglycerides) becomes inaccurate and LDL cholesterol must be directly measured.
- A.
150
- B.
200
- C.
300
- D.
400
- E.
500
Correct Answer
D. 400 -
- 5.
The risk of atherosclerosis is directly related to increasing levels of serum cholesterol.
- A.
True
- B.
False
Correct Answer
A. True -
- 6.
Metabolic syndrome criteria include: increased waist (male >40, female>35), triglycerides greater than or equal to 150, increased HDL (male < ____, female < ____), and fasting blood sugar greater than or equal to 100.
- A.
40,40
- B.
40,50
- C.
50,40
- D.
50,50
Correct Answer
B. 40,50 -
- 7.
Estrogens decrease triglycerides.
- A.
True
- B.
False
Correct Answer
B. False -
- 8.
Typically, ______ are the medications of choice to treat high LDL cholesterol because of their ability to substantially reduce LDL cholesterol, ability to reduce morbidity and mortality from atherosclerotic disease, convenient once daily dosing, and low risk of side effects.
- A.
BAS
- B.
Statins
- C.
Niacin
- D.
Fibrates
- E.
Cholesterol absorption inhibitors
Correct Answer
B. Statins -
- 9.
Patients with metabolic syndrome are twice as likely to develop type 2 DM and four times more likely to develop CHD.
- A.
True
- B.
False
Correct Answer
A. True -
- 10.
Patients with metabolic syndrome have an additional lipid parameter that needs to be assessed, namely non-HDL cholesterol. The target for non-HDL cholesterol is...
- A.
Less than the patient's LDL cholesterol target + 30
- B.
Less than the patient's LDL cholesterol target - 30
Correct Answer
A. Less than the patient's LDL cholesterol target + 30 -
- 11.
Patients with serum triglycerides exceeding _____mg/dL are at increased risk of pancreatitis. Reducing triglycerides in these individuals becomes the primary target for intervention.
- A.
150
- B.
200
- C.
300
- D.
400
- E.
500
Correct Answer
E. 500 -
- 12.
Which three drugs are the most effective agents in patients with hypertriglyceridemia?
- A.
Statins
- B.
Fibrates
- C.
Niacin
- D.
BAS
- E.
Fish oils
Correct Answer(s)
B. Fibrates
C. Niacin
E. Fish oils -
- 13.
Which drug may increase triglycerides?
- A.
Statins
- B.
Bile acid sequestrants
- C.
Cholesterol absorption inhibitors
- D.
Fibric acid derivatives
- E.
Nicotinic acid
Correct Answer
B. Bile acid sequestrants -
- 14.
Main side effects of bile acid sequestrants are nausea, constipation, bloating, and flatulence, although these may be less with ______________. Increasing fluid and dietary fiber intake may relieve constipation and bloating. Impaired absorption of fat-soluble vitamins may also occur.
- A.
Cholestyramine
- B.
Colesevelam
- C.
Colestipol
Correct Answer
B. Colesevelam -
- 15.
Liver function tests should be obtained at baseline and ____________ after starting therapy or ANY dose escalation of a statin.
- A.
6 to 12 days
- B.
4 to 6 days
- C.
6 to 12 weeks (about every 3 months)
- D.
4 to 6 weeks (about every month)
- E.
4 to 6 months
Correct Answer
C. 6 to 12 weeks (about every 3 months) -
- 16.
Limitations of niacin IR and SR are flushing and nephrotoxicity.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
HEPATOTOXICITYRate this question:
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- 17.
"No flush" niacin products are generally effective.
- A.
True
- B.
False
Correct Answer
B. False -
- 18.
Wine...
- A.
Increases HDL, decreases CRP
- B.
Decreases HDL, decreases CRP
- C.
Increases HDL, increases CRP
- D.
Decreases HDL, increases CRP
Correct Answer
A. Increases HDL, decreases CRP -
- 19.
Niacin is "pushes everything in the right direction" but it increases Lp(a).
- A.
True, it increases Lp(a)
- B.
False, it decreases Lp(a)
Correct Answer
B. False, it decreases Lp(a) -
- 20.
Which two statins decrease LDL the most?
- A.
Atorvastatin
- B.
Simvastatin
- C.
Rosuvastatin
- D.
Lovastatin
- E.
Pravastatin
Correct Answer(s)
A. Atorvastatin
C. Rosuvastatin -
- 21.
Gemfibrozil can signficantly increase the concentration of a statin. Amiodarone and simvastatin are especially bad together. What other drugs may increase the risk of myopathy with statins? Select all that apply.
- A.
Ketoconazole
- B.
Cyclosporine
- C.
Verapamil
- D.
Macrolide antibiotics (such as erythromycin and clarithromycin)
- E.
Other fibrates than gemfibrozil
Correct Answer(s)
A. Ketoconazole
B. Cyclosporine
C. Verapamil
D. Macrolide antibiotics (such as erythromycin and clarithromycin)
E. Other fibrates than gemfibrozil -
- 22.
Omega-3s are triglyceride lowering at doses of 2000 to 5000 mg/day. At what dose are they cardioprotective?
- A.
500-1000
- B.
1000-2000
- C.
2000-3000
- D.
2000-5000
- E.
5000+
Correct Answer
B. 1000-2000 -
- 23.
A patient comes to the pharmacy and asks you whether taking a natural product containing plant sterols (such as Cholest Off) will actually decrease her LDL cholesterol. You tell her...
- A.
No, not really
- B.
Maybe, but it won't do much
- C.
Yes, it can lower it by 10 to 15%
Correct Answer
C. Yes, it can lower it by 10 to 15% -
- 24.
A patient comes into her pharmacy and tells you that his doctor told him is Lp(a) was 45 mg/dL. He wants to know if there is anything he can do to get the number back to its normal level. You tell him...
- A.
The number is too low, try exercising then seeing your doctor again.
- B.
The number is too low, take niacin.
- C.
The number is too high, there isn't an effective treatment to reduce this number.
- D.
The number is too high, take niacin.
Correct Answer
D. The number is too high, take niacin. -
- 25.
The patient then tells you that he has diabetes. Is it safe for him to take niacin?
- A.
No
- B.
Yes, at doses less than 500 mg/day
- C.
Yes, at doses less than 1500 mg/day
Correct Answer
C. Yes, at doses less than 1500 mg/day -
- 26.
He then tells you that his biggest fear is to get hepatoxicity. What do you tell him?
- A.
Niacin will probably cause hepatoxicity.
- B.
Taking doses less than 2000mg/day and avoiding SR formulations is not likely to cause hepatoxicity
- C.
Niacin usually causes nephrotoxicity at high doses, not hepatotoxicity
Correct Answer
B. Taking doses less than 2000mg/day and avoiding SR formulations is not likely to cause hepatoxicity -
- 27.
The patient buys niacin and returns the next day saying that it caused too much flushing. What do you recommend?
- A.
Take the flush free formulation
- B.
Take 325mg of ASA or 200mg of ibuprofen 30 minutes before taking niacin.
- C.
Take 81mg of ASA or 200mg of ibuprofen a couple of hours before taking niacin.
Correct Answer
B. Take 325mg of ASA or 200mg of ibuprofen 30 minutes before taking niacin. -
- 28.
Which plays the largest role in reverse cholesterol transport?
- A.
LDL
- B.
HDL
- C.
Chylomicrons
- D.
VLDL
- E.
IDL
Correct Answer
B. HDL -
- 29.
An elderly normotensive woman comes up to you and asks you what her LDL goal should be. She has never smoked, does not have metabolic syndrome, does not have a family history of heart related problems, and has no other risk equivalents such as MI, angina, stents, PAD, diabetes, etc. You tell her...
- A.
She doesn't have any risk factors and not to worry.
- B.
Her age is a risk factor and her LDL should be less than 130 mg/dL
- C.
Her age is a risk factor and her LDL should be less than 100 mg/dL
- D.
None of above
Correct Answer
D. None of aboveExplanation
With just one risk factor (such as old age) LDL goal can be less than 160.Rate this question:
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Current Version
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Nov 22, 2018Quiz Edited by
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Sep 14, 2010Quiz Created by
Caitlinb
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