Hyperlipidemia
This Hyperlipidemia quiz assesses knowledge on lipid transport mechanisms, types of lipoproteins, and secondary causes of hypercholesterolemia. It is designed to enhance understanding of lipid metabolism and its clinical implications, crucial for medical students and professionals.
- 1.
___________ carries ~10 to 15 % of total serum cholesterol; carried in circulation as TG; ______ = TG/5
- A.
LDL
- B.
VLDL
- C.
HDL
- D.
IDL
Correct Answer
B. VLDLExplanation
VLDL, or very low-density lipoprotein, carries approximately 10 to 15% of total serum cholesterol. It is transported in the circulation as triglycerides (TG). The ratio of TG to VLDL is TG divided by 5.Rate this question:
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- 2.
___________ carries 60 to 70% of total serum cholesterol; IDL is also included in this group
- A.
LDL
- B.
HDL
- C.
TG
- D.
VLDL
Correct Answer
A. LDLExplanation
LDL (low-density lipoprotein) carries 60 to 70% of total serum cholesterol. This means that LDL is responsible for transporting a significant portion of the cholesterol in the bloodstream. IDL (intermediate-density lipoprotein) is also included in this group, further supporting the fact that LDL is the correct answer.Rate this question:
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- 3.
__________ carries 20 to 30% of total serum cholesterol; reverse transportation of cholesterol
- A.
VLDL
- B.
HG
- C.
HDL
- D.
LDL
Correct Answer
C. HDLExplanation
HDL (high-density lipoprotein) carries 20 to 30% of total serum cholesterol and is involved in the reverse transportation of cholesterol. HDL is often referred to as "good cholesterol" because it helps remove excess cholesterol from the bloodstream and transports it back to the liver for processing and elimination. This process helps prevent the buildup of cholesterol in the arteries and reduces the risk of heart disease.Rate this question:
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- 4.
žVLDL secreted from the ______________ —converted to IDL then LDL
Correct Answer
liverExplanation
The VLDL (Very Low-Density Lipoprotein) is initially secreted from the liver. However, through various enzymatic reactions, it gets converted first into IDL (Intermediate-Density Lipoprotein) and then into LDL (Low-Density Lipoprotein). Therefore, the correct answer is the liver.Rate this question:
- 5.
Plasma LDL taken up by receptors on _______________ (Choose all that apply)
- A.
Liver
- B.
Kidney
- C.
Adrenal
- D.
Peripheral cells
- E.
Juxtaglomerular cells
- F.
Thyroid
Correct Answer(s)
A. Liver
C. Adrenal
D. Peripheral cellsExplanation
Plasma LDL is taken up by receptors on the liver, adrenal glands, and peripheral cells. These receptors help in the clearance of LDL from the bloodstream, preventing its accumulation and reducing the risk of cardiovascular diseases. The liver plays a crucial role in LDL metabolism and is responsible for the majority of LDL uptake. The adrenal glands also possess LDL receptors, which aid in the production of hormones. Peripheral cells, including those in the muscle and adipose tissue, can also take up LDL to meet their metabolic needs.Rate this question:
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- 6.
What are the secondary causes of hypercholesterolemia?
- A.
Hypothyroidism
- B.
Obstructive liver disease
- C.
Nephrotic syndrome
- D.
Anorexia nervosa
- E.
Acute intermittent porphyria
Correct Answer(s)
A. Hypothyroidism
B. Obstructive liver disease
C. Nephrotic syndrome
D. Anorexia nervosa
E. Acute intermittent porphyriaExplanation
Hypercholesterolemia refers to high levels of cholesterol in the blood. The secondary causes of hypercholesterolemia listed in the answer options include hypothyroidism, obstructive liver disease, nephrotic syndrome, anorexia nervosa, and acute intermittent porphyria. These conditions can contribute to increased cholesterol levels in different ways. Hypothyroidism, for example, can lead to decreased metabolism and impaired clearance of cholesterol. Obstructive liver disease can disrupt the normal processing of cholesterol by the liver. Nephrotic syndrome can result in increased cholesterol production and decreased clearance. Anorexia nervosa can cause alterations in lipid metabolism. Acute intermittent porphyria can lead to abnormalities in cholesterol synthesis.Rate this question:
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- 7.
Choose three medications that have secondary side effects of hypercholesterolemia?
- A.
Thiazide diuretics
- B.
Protease inhibitors
- C.
β-blockers
- D.
Interferons
- E.
Estrogens
- F.
Alcohol
Correct Answer(s)
A. Thiazide diuretics
B. Protease inhibitors
C. β-blockersExplanation
Thiazide diuretics, protease inhibitors, and β-blockers are medications that have secondary side effects of hypercholesterolemia. Thiazide diuretics are commonly used to treat hypertension and can increase cholesterol levels. Protease inhibitors are antiviral medications used to treat HIV and can also cause elevated cholesterol levels. β-blockers are medications used to treat conditions such as high blood pressure and heart disease, and they can potentially raise cholesterol levels as well.Rate this question:
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- 8.
What are the secondary causes of Hypertriglyceridemia?
- A.
Hypothyroidism
- B.
Obesity
- C.
Nephrotic syndrome
- D.
Diabetes
- E.
Acute intermittent porphyria
Correct Answer(s)
B. Obesity
D. DiabetesExplanation
Obesity and diabetes are both secondary causes of hypertriglyceridemia. Obesity is characterized by excess body fat, which can lead to elevated levels of triglycerides in the blood. Diabetes, specifically type 2 diabetes, is often associated with insulin resistance, which can also contribute to high triglyceride levels. These conditions can disrupt the normal metabolism of fats in the body, leading to hypertriglyceridemia.Rate this question:
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- 9.
Choose three medications that have secondary side effects of Hypertriglyceridemia?
- A.
Thiazide diuretics
- B.
Protease inhibitors
- C.
β-blockers
- D.
Interferons
- E.
Estrogens
- F.
Alcohol
Correct Answer(s)
A. Thiazide diuretics
C. β-blockers
D. Interferons
E. Estrogens
F. AlcoholExplanation
Thiazide diuretics, β-blockers, and estrogens are known to have secondary side effects of hypertriglyceridemia. Thiazide diuretics are commonly used to treat high blood pressure and can increase triglyceride levels. β-blockers, which are used to treat conditions such as hypertension and angina, can also cause an increase in triglycerides. Estrogens, typically prescribed for hormone replacement therapy or birth control, can raise triglyceride levels as well. Additionally, alcohol consumption has been linked to hypertriglyceridemia. Interferons, on the other hand, do not have a known association with elevated triglycerides.Rate this question:
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- 10.
What are the secondary causes of Hypocholesterolemia?
- A.
Hypothyroidism
- B.
Obesity
- C.
Malnutrition
- D.
Diabetes
- E.
Malabsorption
Correct Answer(s)
C. Malnutrition
E. MalabsorptionExplanation
Malnutrition and malabsorption are the secondary causes of hypocholesterolemia. Hypocholesterolemia refers to low levels of cholesterol in the blood, and it can be caused by various factors. Malnutrition occurs when the body does not receive enough nutrients, including cholesterol, through the diet. Malabsorption, on the other hand, refers to the inability of the body to absorb nutrients properly, including cholesterol. These two conditions can lead to hypocholesterolemia by reducing the intake or absorption of cholesterol, resulting in low levels in the blood.Rate this question:
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- 11.
What are the secondary causes of Low high-density lipoprotein?
- A.
Hypothyroidism
- B.
Obesity
- C.
Malnutrition
- D.
Diabetes
- E.
Malabsorption
Correct Answer(s)
B. Obesity
C. MalnutritionExplanation
The question asks for the secondary causes of low high-density lipoprotein (HDL), which is commonly known as "good cholesterol". HDL helps remove bad cholesterol from the bloodstream, reducing the risk of heart disease. Among the given options, obesity and malnutrition are the secondary causes of low HDL. Obesity is associated with an imbalance in lipid metabolism, leading to decreased HDL levels. Malnutrition, on the other hand, can result in low HDL due to inadequate intake of essential nutrients.Rate this question:
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- 12.
Signs of hyperlipidemia include a BMI > ___________kg/m2
Correct Answer(s)
30 kg/m2
30Explanation
Hyperlipidemia is a condition characterized by high levels of lipids (such as cholesterol and triglycerides) in the blood. One of the signs used to diagnose hyperlipidemia is a high BMI (Body Mass Index). A BMI greater than 30 kg/m2 indicates obesity, which is commonly associated with hyperlipidemia. Therefore, a BMI of 30 kg/m2 is considered a sign of hyperlipidemia.Rate this question:
- 13.
Signs of hyperlipidemia include a waist size > ________ in (men), > _________ in (women)
Correct Answer(s)
40, 35Explanation
The correct answer to the question is 40 for men and 35 for women. These numbers represent the waist size thresholds that indicate signs of hyperlipidemia, a condition characterized by high levels of lipids (fats) in the blood. Excess fat around the waist is associated with an increased risk of cardiovascular disease and metabolic disorders. Therefore, a waist size greater than 40 inches in men and 35 inches in women suggests the presence of hyperlipidemia.Rate this question:
- 14.
What is the correct formula to measure total cholesterol
- A.
TC=HDL+IDL+(TG/5)
- B.
TC=HDL+VLDL+(TG/5)
- C.
TC=HDL+LDL+TG
- D.
TC=HDL+LDL+(TG/5)
Correct Answer
D. TC=HDL+LDL+(TG/5)Explanation
The correct formula to measure total cholesterol is TC=HDL+LDL+(TG/5). This formula takes into account the levels of high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglycerides (TG) in the blood. TG is divided by 5 because it is measured in milligrams per deciliter (mg/dL), while the other components are measured in millimoles per liter (mmol/L). Adding up the values of HDL, LDL, and TG/5 gives the total cholesterol (TC) level.Rate this question:
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- 15.
The following are all Major Risk Factors (Exclusive of LDL Cholesterol) That Modify LDL Goals except
- A.
Cigarette smoking
- B.
Family history of premature CHD;CHD in male first degree relative
- C.
Hypertension (BP >140/90 mmHg or on antihypertensive medication)
- D.
Low HDL cholesterol (
- E.
Age (men >/=45 years; women >/=55 years)
- F.
High fat diet
Correct Answer
F. High fat dietExplanation
High fat diet is not a major risk factor that modifies LDL goals. The other risk factors listed, such as cigarette smoking, family history of premature CHD, hypertension, low HDL cholesterol, and age, are all known to have an impact on LDL goals. However, a high fat diet, while it can contribute to high cholesterol levels, is not specifically mentioned as a risk factor that modifies LDL goals.Rate this question:
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- 16.
What are the CHD Risk Equivalents?
- A.
Multiple risk factors that confer a 10-year risk for CHD >20%
- B.
Diabetes
- C.
Peripheral arterial disease, abdominal aortic aneurysm, and symptomatic carotid artery disease
Correct Answer(s)
A. Multiple risk factors that confer a 10-year risk for CHD >20%
B. Diabetes
C. Peripheral arterial disease, abdominal aortic aneurysm, and symptomatic carotid artery diseaseExplanation
The CHD Risk Equivalents are multiple risk factors that increase the risk of developing coronary heart disease (CHD) over a 10-year period to more than 20%. These risk factors include diabetes, peripheral arterial disease, abdominal aortic aneurysm, and symptomatic carotid artery disease. These conditions are considered to be equivalent to having a high risk of CHD and require aggressive management and treatment to prevent cardiovascular events.Rate this question:
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- 17.
Therapeutic Lifestyle Changes (TLC) include all of the following except
- A.
Encourage moderate physical activity
- B.
Increase fiber intake
- C.
Emphasize reduction in saturated fat & cholesterol
- D.
Consider referral to a dietitian
- E.
Increase physical activity to everyday for 30 minutes
Correct Answer
E. Increase physical activity to everyday for 30 minutesExplanation
The given correct answer is "Increase physical activity to everyday for 30 minutes." This is because the other options listed - encouraging moderate physical activity, increasing fiber intake, emphasizing reduction in saturated fat and cholesterol, and considering referral to a dietitian - are all examples of Therapeutic Lifestyle Changes (TLC). However, increasing physical activity to everyday for 30 minutes does not fall under the category of TLC, as it does not specify any specific changes or recommendations related to physical activity.Rate this question:
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- 18.
Most patients should receive __________ TLC trial before initiating pharmacologic therapy unless very high risk
Correct Answer
3 month
3 monthsExplanation
The correct answer is "3 months". This is because most patients should undergo a 3-month trial of therapeutic lifestyle changes (TLC) before starting pharmacologic therapy, unless they are considered to be at very high risk. This trial period allows patients to make necessary lifestyle modifications such as adopting a healthy diet, increasing physical activity, and quitting smoking, which can potentially improve their condition without the need for medication.Rate this question:
- 19.
All the following are used Primary Prevention to Initiate LDL-lowering drug therapy except
- A.
Bile acid sequestrant
- B.
Ezetimibe
- C.
Statin
- D.
Nicotinic acid
Correct Answer
B. EzetimibeExplanation
Ezetimibe is not used as a primary prevention to initiate LDL-lowering drug therapy. Bile acid sequestrants, statins, and nicotinic acid are commonly used to lower LDL cholesterol levels and prevent cardiovascular events. Ezetimibe, on the other hand, is typically used as an adjunct therapy when statins alone are not sufficient in lowering LDL cholesterol. It works by inhibiting the absorption of cholesterol in the small intestine.Rate this question:
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- 20.
If a patient is taking Atorvastatin (Lipitor ®): 10 mg, what is the equivalent Fluvastatin (Lescol ®) dose?
Correct Answer
80 mgExplanation
Atorvastatin and Fluvastatin are both statin medications used to lower cholesterol levels. The question is asking for the equivalent dose of Fluvastatin if a patient is taking Atorvastatin 10 mg. The correct answer is 80 mg. This means that if a patient is taking Atorvastatin 10 mg, they would need to take Fluvastatin 80 mg to achieve the same therapeutic effect.Rate this question:
- 21.
If a patient is taking Atorvastatin (Lipitor ®): 10 mg, what is the equivalent Lovastatin (Mevacor ®) dose?
Correct Answer
40 mgExplanation
Atorvastatin (Lipitor) and Lovastatin (Mevacor) are both medications used to lower cholesterol levels. The question is asking for the equivalent dose of Lovastatin if the patient is taking 10 mg of Atorvastatin. The correct answer is 40 mg because Lovastatin is typically prescribed at a higher dose compared to Atorvastatin. Therefore, to achieve a similar cholesterol-lowering effect, a higher dose of Lovastatin is required.Rate this question:
- 22.
If a patient is taking Atorvastatin (Lipitor ®): 10 mg, what is the equivalent Pravastatin (Pravachol ®) dose?
Correct Answer
40 mgExplanation
Atorvastatin and Pravastatin are both medications used to lower cholesterol levels. The question asks for the equivalent Pravastatin dose for a patient taking 10 mg of Atorvastatin. The answer is 40 mg because the conversion ratio between Atorvastatin and Pravastatin is 1:4. This means that 10 mg of Atorvastatin is equivalent to 40 mg of Pravastatin.Rate this question:
- 23.
If a patient is taking Atorvastatin (Lipitor ®): 10 mg, what is the equivalent Rosuvastatin (Crestor ®) dose?
Correct Answer
5 mgExplanation
Atorvastatin and Rosuvastatin are both statin medications used to lower cholesterol levels. The question asks for the equivalent dose of Rosuvastatin if the patient is taking 10 mg of Atorvastatin. The correct answer is 5 mg because Rosuvastatin is generally considered to be twice as potent as Atorvastatin. Therefore, a 10 mg dose of Atorvastatin is equivalent to a 5 mg dose of Rosuvastatin.Rate this question:
- 24.
If a patient is taking Atorvastatin (Lipitor ®): 10 mg, what is the equivalent Simvastatin (Zocor ®) dose?
Correct Answer
20 mgExplanation
Atorvastatin (Lipitor) and Simvastatin (Zocor) are both statin medications used to lower cholesterol levels. The question asks for the equivalent Simvastatin dose for a patient taking 10 mg of Atorvastatin. Since the answer is 20 mg, it suggests that the two medications have a 1:2 conversion ratio. In other words, 10 mg of Atorvastatin is equivalent to 20 mg of Simvastatin.Rate this question:
- 25.
Statin side effects are often class specific, not always agent specific
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
Statin side effects are often agent specific, not always class specificRate this question:
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- 26.
What two statins have no active metabolites?
- A.
Lovastatin
- B.
Simvastatin
- C.
Pravastatin
- D.
Fluvastatin
- E.
Atorvastatin
- F.
Rosuvastatin
Correct Answer(s)
C. Pravastatin
D. FluvastatinExplanation
Pravastatin and fluvastatin are the two statins that have no active metabolites. This means that they are not converted into any active form in the body and are eliminated from the body as they are. This characteristic can be advantageous in patients with liver or kidney problems, as these statins have a lower risk of drug-drug interactions and are less likely to accumulate in the body.Rate this question:
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- 27.
What two statins are not lipophilic?
- A.
Lovastatin
- B.
Simvastatin
- C.
Pravastatin
- D.
Fluvastatin
- E.
Atorvastatin
- F.
Rosuvastatin
Correct Answer(s)
C. Pravastatin
F. RosuvastatinExplanation
Pravastatin and Rosuvastatin are the two statins that are not lipophilic. Lipophilic statins have a high affinity for fat and are more likely to penetrate cell membranes, while hydrophilic statins have a low affinity for fat and are less likely to penetrate cell membranes. Pravastatin and Rosuvastatin are hydrophilic statins, meaning they do not easily cross cell membranes and are less likely to cause certain side effects associated with lipophilic statins, such as muscle pain or liver damage.Rate this question:
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- 28.
What two statins have long elimination half-life's?
- A.
Lovastatin
- B.
Simvastatin
- C.
Pravastatin
- D.
Fluvastatin
- E.
Atorvastatin
- F.
Rosuvastatin
Correct Answer(s)
E. Atorvastatin
F. RosuvastatinExplanation
Atorvastatin and Rosuvastatin have long elimination half-lives. This means that it takes a relatively long time for these drugs to be cleared from the body. The longer half-life allows for a once-daily dosing regimen, which is convenient for patients.Rate this question:
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- 29.
Which statin requires dosage adjustment for severe renal impairment & hepatic disease
- A.
Lovastatin
- B.
Simvastatin
- C.
Pravastatin
- D.
Fluvastatin
- E.
Atorvastatin
- F.
Rosuvastatin
Correct Answer
F. RosuvastatinExplanation
Rosuvastatin requires dosage adjustment for severe renal impairment and hepatic disease. This means that individuals with severe kidney or liver problems may need to take a lower dose of rosuvastatin to avoid potential side effects or complications. The other statins listed in the question do not require dosage adjustment for these conditions.Rate this question:
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- 30.
What statin(s) utilize the isoenzyme 3A4?
- A.
Lovastatin
- B.
Simvastatin
- C.
Pravastatin
- D.
Fluvastatin
- E.
Atorvastatin
- F.
Rosuvastatin
Correct Answer(s)
A. Lovastatin
B. Simvastatin
E. AtorvastatinExplanation
Lovastatin, simvastatin, and atorvastatin utilize the isoenzyme 3A4. This means that these statins are metabolized by the 3A4 enzyme in the liver. The 3A4 enzyme is responsible for breaking down drugs and other substances in the body. Therefore, individuals who are taking medications that inhibit or induce the 3A4 enzyme may experience interactions or changes in the metabolism of these statins. It is important to consider these interactions when prescribing or taking these medications to ensure their effectiveness and safety.Rate this question:
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- 31.
What statin(s) utilize the isoenzyme 2C9?
- A.
Lovastatin
- B.
Simvastatin
- C.
Pravastatin
- D.
Fluvastatin
- E.
Atorvastatin
- F.
Rosuvastatin
Correct Answer(s)
D. Fluvastatin
F. RosuvastatinExplanation
Fluvastatin and rosuvastatin utilize the isoenzyme 2C9.Rate this question:
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- 32.
What statin(s) do NOT utilize any isoenzyme system?
- A.
Lovastatin
- B.
Simvastatin
- C.
Pravastatin
- D.
Fluvastatin
- E.
Atorvastatin
- F.
Rosuvastatin
Correct Answer
C. PravastatinExplanation
Pravastatin is the correct answer because it does not utilize any isoenzyme system. Isoenzyme systems are responsible for the metabolism of statins in the body. Lovastatin, simvastatin, fluvastatin, atorvastatin, and rosuvastatin all utilize the CYP3A4 isoenzyme system for metabolism. However, pravastatin is predominantly metabolized by non-CYP isoenzymes, such as sulfotransferases and acyl-CoA synthetases, making it unique among statins.Rate this question:
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- 33.
Unexplained myalgias may occur on statins without CK elevation.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
Unexplained myalgias can indeed occur in individuals taking statins without an elevation in creatine kinase (CK) levels. Statins are commonly prescribed medications used to lower cholesterol levels, but they can sometimes cause muscle pain or myalgias as a side effect. While an increase in CK levels is often seen in individuals experiencing statin-induced myalgias, there are cases where myalgias occur without any elevation in CK levels. Therefore, it is true that unexplained myalgias may occur on statins without CK elevation.Rate this question:
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- 34.
Statins Lowers LDL-C and Raises HDL-C by
- A.
5%–25%, 15%–35%
- B.
15%–30%, 3%–5%
- C.
21%–63%, 3%–16%
- D.
10%–30%, 3%–15%
Correct Answer
C. 21%–63%, 3%–16%Explanation
Statins are a type of medication commonly prescribed to lower cholesterol levels. LDL-C refers to low-density lipoprotein cholesterol, which is considered "bad" cholesterol, while HDL-C refers to high-density lipoprotein cholesterol, which is considered "good" cholesterol. The given answer states that statins can lower LDL-C levels by 21%–63% and raise HDL-C levels by 3%–16%. This means that statins can significantly reduce the levels of bad cholesterol while also increasing the levels of good cholesterol in the body.Rate this question:
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- 35.
Bile Acid Resins Lowers LDL-C and Raises HDL-C by
- A.
5%–25%, 15%–35%
- B.
15%–30%, 3%–5%
- C.
21%–63%, 3%–16%
- D.
10%–30%, 3%–15%
Correct Answer
B. 15%–30%, 3%–5%Explanation
Bile acid resins are a class of drugs that are used to lower LDL cholesterol levels and raise HDL cholesterol levels. They work by binding to bile acids in the intestine, preventing their reabsorption and promoting their excretion. This leads to an increase in the conversion of cholesterol into bile acids, resulting in a decrease in LDL cholesterol levels. The range of 15%–30% represents the typical reduction in LDL cholesterol levels achieved with bile acid resins. Additionally, bile acid resins can also increase HDL cholesterol levels by 3%–5%, although this increase is generally modest compared to the reduction in LDL cholesterol.Rate this question:
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- 36.
Niacin Lowers LDL-C and Raises HDL-C by
- A.
5%–25%, 15%–35%
- B.
15%–30%, 3%–5%
- C.
21%–63%, 3%–16%
- D.
10%–30%, 3%–15%
Correct Answer
A. 5%–25%, 15%–35%Explanation
Niacin has been shown to lower LDL-C (low-density lipoprotein cholesterol) levels by 5% to 25% and raise HDL-C (high-density lipoprotein cholesterol) levels by 15% to 35%.Rate this question:
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- 37.
Which one of the following is a proper recommendation regarding general therapeutic lifestyle changes?
- A.
Limit carbohydrates to less than 40% of calories daily.
- B.
Increase monounsaturated fats to 30% of total calories.
- C.
Encourage alcohol consumption of at least three drinks per day.
- D.
Take a supplement with an antioxidant such as vitamin A for additional cardioprotection.
- E.
Limit cholesterol consumption to less than 200 mg/d.
Correct Answer
E. Limit cholesterol consumption to less than 200 mg/d.Explanation
The proper recommendation regarding general therapeutic lifestyle changes is to limit cholesterol consumption to less than 200 mg/d. This is because high cholesterol levels can increase the risk of heart disease and limiting cholesterol intake can help maintain a healthy heart.Rate this question:
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- 38.
Identify a baseline laboratory test required before statin treatment.
- A.
White blood cell count
- B.
Complete blood cell count
- C.
Liver function test
- D.
Serum creatinine
- E.
Creatinine clearance
Correct Answer
C. Liver function testExplanation
Before starting statin treatment, it is important to conduct a baseline liver function test. This test helps to assess the health and functioning of the liver before initiating statin therapy. Statins are known to potentially cause liver damage or abnormal liver function, so it is essential to ensure that the liver is healthy before starting treatment. This baseline test provides a reference point to monitor any changes in liver function during the course of statin therapy.Rate this question:
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- 39.
Which of the following is NOT a secondary cause of hyperlipidemia?
- A.
High LDL
- B.
Hypothyroidism
- C.
Diabetes
- D.
Renal disease
- E.
Beta-Blockers
Correct Answer
A. High LDLExplanation
Causes of hyperlipidemia must be ruled out. The common secondary causes are renal failure, hypothyroidism, obstructive liver disease, diabetes, and drugs such as beta-blockers, thiazide diuretics, oral contraceptives, oral estrogens, glucocorticoids, and cyclosporine.Rate this question:
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- 40.
Polygenic hypercholesterolemia is characterized by which of the following?
- A.
LDL = 150-450 mg/dL
- B.
LDL = 160-250 mg/dL
- C.
Triglycerides greater than 400 mg/dL
- D.
HDL = 50 mg/dL
- E.
LDL = 160-250 mg/dL + triglycerides greater than 400 mg/dL
Correct Answer
B. LDL = 160-250 mg/dLExplanation
Polygenic hypercholesterolemia is characterized by LDL levels ranging from 160-250 mg/dL. This means that individuals with polygenic hypercholesterolemia typically have higher levels of LDL cholesterol in their blood, which puts them at a higher risk for cardiovascular diseases such as heart attacks and strokes. The other options, such as LDL levels of 150-450 mg/dL or triglycerides greater than 400 mg/dL, are not specific to polygenic hypercholesterolemia and may indicate other conditions or risk factors. The HDL level of 50 mg/dL is not directly related to polygenic hypercholesterolemia.Rate this question:
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- 41.
Which of the following medications requires dose adjustment in patients with renal insufficiency?
- A.
Milrinone
- B.
Hydralazine
- C.
Metoprolol
- D.
Dopamine
- E.
Nesiritide
Correct Answer
A. MilrinoneExplanation
EXPLANATION: Milrinone is partially eliminated by the kidneysand, thus, requires dose adjustment in patients with renal insufficiency.Rate this question:
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- 42.
J. I. is a 57-year-old African American woman who presents to your pharmacy asking for advice on her new “cholesterol pill.” Her medical history is significant for obesity and asthma. She has no other significant medical conditions. Her social history indicates that she does not drink, but she has smoked a pack of cigarettes daily for the past 7 years. Her family history indicates that her mother suffered a myocardial infarction at age 63, while her father had a myocardial infarction at age 60. Her current medications include ranitidine 75 daily prn for “heartburn” along with a new prescription for simvastatin 20 mg/daily. A physical assessment reveals the following: BP 112/83 mm Hg, pulse 73 bpm, weight 173 lbs, and height 5 feet 3 inches. You find that her lipid measurements are as follows: LDL, 177 mg/dL; HDL, 43 mg/dL; and triglycerides, 153 mg/dL. When should J. I.’s lipid therapy be evaluated for effectiveness in correcting her dyslipidemia?
- A.
Two weeks
- B.
Six weeks
- C.
Three months
- D.
Six months
- E.
Yearly
Correct Answer
B. Six weeksExplanation
J. I.'s lipid therapy should be evaluated for effectiveness in correcting her dyslipidemia after six weeks. This is because it takes some time for the medication to start working and show its effects on lipid levels in the body. By evaluating her lipid levels after six weeks, healthcare professionals can assess if the prescribed medication, simvastatin 20 mg/daily, is effectively reducing her LDL cholesterol levels and improving her dyslipidemia. This timeframe allows for an adequate period to observe any changes in lipid levels and make any necessary adjustments to the treatment plan if needed.Rate this question:
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- 43.
Combining ezetimibe with which one of the following medications may result in an increased risk of gallbladder disease?
- A.
Fenofibrate
- B.
Lovastatin
- C.
Colestipol
- D.
Immediate-release nicotinic acid
- E.
Omega-3 fatty acids
Correct Answer
A. FenofibrateExplanation
Combining ezetimibe with fenofibrate may result in an increased risk of gallbladder disease. This is because both medications have been associated with an increased incidence of gallstones and gallbladder-related adverse events. Therefore, caution should be exercised when using these two medications together, and patients should be monitored closely for any signs or symptoms of gallbladder disease.Rate this question:
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- 44.
Which of the following classes of drugs works by reducing the production of mevalonate, ultimately inhibiting the rate limiting step in cholesterol synthesis?
- A.
HMG-CoA reductase inhibitors
- B.
Bile acid sequestrants
- C.
Fibric acids
- D.
Nicotinic acid
- E.
Omega-3 fatty acids
Correct Answer
A. HMG-CoA reductase inhibitorsExplanation
HMG-CoA reductase inhibitors work by reducing the production of mevalonate, which is the rate limiting step in cholesterol synthesis. By inhibiting this step, these drugs effectively lower cholesterol levels in the body. Bile acid sequestrants work by binding to bile acids in the intestine, preventing their reabsorption and promoting the excretion of cholesterol. Fibric acids work by activating a specific receptor that increases the breakdown of triglycerides and decreases the production of cholesterol. Nicotinic acid works by inhibiting the release of free fatty acids from adipose tissue, which in turn reduces the production of triglycerides and LDL cholesterol. Omega-3 fatty acids work by reducing the liver's production of triglycerides.Rate this question:
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- 45.
J. I. is a 57-year-old African American woman who presents to your pharmacy asking for advice on her new “cholesterol pill.” Her medical history is significant for obesity and asthma. She has no other significant medical conditions. Her social history indicates that she does not drink, but she has smoked a pack of cigarettes daily for the past 7 years. Her family history indicates that her mother suffered a myocardial infarction at age 63, while her father had a myocardial infarction at age 60. Her current medications include ranitidine 75 daily prn for “heartburn” along with a new prescription for simvastatin 20 mg/daily. A physical assessment reveals the following: BP 112/83 mm Hg, pulse 73 bpm, weight 173 lbs, and height 5 feet 3 inches. You find that her lipid measurements are as follows: LDL, 177 mg/dL; HDL, 43 mg/dL; and triglycerides, 153 mg/dL. Which of the following represents the most appropriate lipid goal for J. I.?
- A.
A total cholesterol level of less than 200 mg/dL
- B.
An HDL of at least 60 mg/dL
- C.
An LDL level less than 160 mg/dL
- D.
An LDL level less than 130 mg/dL
- E.
A triglyceride level less than 150 mg/dL
Correct Answer
D. An LDL level less than 130 mg/dLExplanation
Based on J.I.'s medical history and lipid measurements, the most appropriate lipid goal for her would be an LDL level less than 130 mg/dL. This is because her LDL level is currently elevated at 177 mg/dL, which puts her at an increased risk for cardiovascular disease. Lowering her LDL level to less than 130 mg/dL would help to reduce this risk and improve her overall cardiovascular health. The other lipid goals mentioned in the options are either not relevant to J.I.'s specific situation or do not address her elevated LDL level.Rate this question:
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- 46.
A TLC diet could include:
- A.
Antioxidant therapy such as vitamin E
- B.
Less than 7% of total calories from saturated fat
- C.
150-250 g/d of fiber
- D.
2-4 drinks of alcohol per day
- E.
Assessing the effectiveness of TLC at 12-week intervals
Correct Answer
B. Less than 7% of total calories from saturated fatExplanation
An explanation for the given correct answer is that a TLC (Therapeutic Lifestyle Changes) diet is a diet plan designed to help lower cholesterol levels and reduce the risk of heart disease. One of the key recommendations of a TLC diet is to limit the intake of saturated fat to less than 7% of total calories. This is because saturated fat has been linked to increased cholesterol levels and can contribute to the development of heart disease. By reducing saturated fat intake, individuals can improve their cholesterol profile and lower their risk of heart disease.Rate this question:
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- 47.
Which of the following medications has the following warning: "For patients switching from immediate-release niacin, therapy with this drug should be initiated with a low dose and then titrated to the desired therapeutic response"?
- A.
Pravigard
- B.
Vytorin
- C.
Advicor
- D.
Atorvastatin
- E.
Ezetimibe
Correct Answer
C. Advicor -
- 48.
Which of the following nonpharmacologic therapies can moderately lower the LDL level if taken in sufficient amounts?
- A.
Antioxidants such as vitamin C
- B.
Alcoholic beverages
- C.
Foods high in saturated fats
- D.
Foods high in soluble fiber such as fruits and whole grains
- E.
Foods high in protein such as lean meats
Correct Answer
D. Foods high in soluble fiber such as fruits and whole grainsExplanation
Foods high in soluble fiber such as fruits and whole grains can moderately lower the LDL level if taken in sufficient amounts. Soluble fiber binds to cholesterol in the digestive system, preventing its absorption into the bloodstream. This leads to a decrease in LDL cholesterol levels. Antioxidants such as vitamin C can have some health benefits, but they do not have a significant impact on LDL levels. Alcoholic beverages and foods high in saturated fats can actually increase LDL levels. Foods high in protein such as lean meats do not directly affect LDL levels.Rate this question:
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- 49.
How long should one wait before taking colestipol if one is taking other medications?
- A.
Two hours after taking another medication and 2 hours before taking another medication
- B.
Four hours after taking another medication and 4 hours before taking another medication
- C.
One hour after taking another medication and 1 hour before taking another medication
- D.
One hour after taking another medication and 4 hours before taking another medication
- E.
Four hours after taking another medication and 1 hour before taking another medication
Correct Answer
D. One hour after taking another medication and 4 hours before taking another medicationExplanation
One should wait for one hour after taking another medication and four hours before taking another medication before taking colestipol. This is important to ensure that the colestipol does not interact with other medications and interfere with their effectiveness. By waiting for a specific time period before and after taking other medications, the potential for any negative drug interactions can be minimized.Rate this question:
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- 50.
What is the name of the fatty streaks that may form in the vascular walls of the arteries as a result of cholesterol accumulation?
- A.
Foam cells
- B.
Endothelial rupture
- C.
Atheroma lesions
- D.
HDL deposits
- E.
Platelet occlusion
Correct Answer
C. Atheroma lesionsExplanation
Atheroma lesions are the name given to the fatty streaks that form in the vascular walls of the arteries due to cholesterol accumulation. These lesions are characterized by the accumulation of cholesterol, immune cells, and cellular debris, leading to the formation of plaque. Over time, these plaques can harden and narrow the arteries, leading to various cardiovascular diseases such as atherosclerosis.Rate this question:
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Mar 21, 2023Quiz Edited by
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Sep 08, 2012Quiz Created by
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