chap 39: Hyperlipidemia Flashcards
The overall goal of treating hyperlipidemia is:
- Maintain an LDL level of less than 160 mg/dL
- To reduce atherogenesis
- Lowering apo B, one of the apoliproteins
- All of the above
- To reduce atherogenesis
When considering which cholesterol-lowering drug to prescribe, which factor determines the type and intensity of treatment?
- Total LDL
- Fasting HDL
- Coronary artery disease risk level
- Fasting total cholesterol
- Coronary artery disease risk level
First-line therapy for hyperlipidemia is:
- Statins
- Niacin
- Lifestyle changes
- Bile acid-binding resins
- Lifestyle changes
James is a 45-year-old patient with an LDL level of 120 and normal triglycerides. Appropriate first-line therapy for James may include diet counseling, increased physical activity, and:
- A statin
- Niacin
- Sterols
- A fibric acid derivative
- Sterols
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 (increased fiber and plant sterols) to lower her LDL and after 6 months her LDL is slightly higher. The next step in her treatment would be:
- A statin
- Niacin
- Sterols
- A fibric acid derivative
- A statin
Sharlene is a 65-year-old patient who has been on a lipid-lowering diet and using plant sterol margarine daily for the past 3 months. Her LDL is 135 mg/dL. An appropriate treatment for her would be:
- A statin
- Niacin
- A fibric acid derivative
- Determined by her risk factors
- Determined by her risk factors
Phil is a 54-year-old male with multiple risk factors who has been on a high-dose statin for 3 months to treat his high LDL level. His LDL is 135 mg/dL and his triglycerides are elevated. A reasonable change in therapy would be to:
- Discontinue the statin and change to a fibric acid derivative.
- Discontinue the statin and change to ezetimibe.
- Continue the statin and add in ezetimibe.
- Refer him to a specialist in managing patients with recalcitrant hyperlipidemia.
- Continue the statin and add in ezetimibe.
Jamie is a 34-year-old pregnant woman with familial hyperlipidemia and elevated LDL levels. What is the appropriate treatment for a pregnant woman?
- A statin
- Niacin
- Fibric acid derivative
- Bile acid-binding resins
- Bile acid-binding resins
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:
- Sterol
- Niacin
- Fibric acid derivative
- Bile acid-binding resin
- Fibric acid derivative
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 reevaluation in 6 months.
- Statins
- Niacin
- Sterols
- Bile acid-binding resins
- Sterols
Monitoring of a patient who is on a lipid-lowering drug includes:
- Fasting total cholesterol every 6 months
- Lipid profile with attention to serum LDL 6 to 8 weeks after starting therapy, then again in 6 weeks
- Complete blood count, C-reactive protein, and erythrocyte sedimentation rate after 6 weeks of therapy
- All of the above
- Lipid profile with attention to serum LDL 6 to 8 weeks after starting therapy, then again in 6 weeks
Before starting therapy with a statin, the following baseline laboratory values should be evaluated:
- Complete blood count
- Liver function (ALT/AST) and creatine kinase
- C-reactive protein
- All of the above
- Liver function (ALT/AST) and creatine kinase
When starting a patient on a statin, education would include:
- If they stop the medication their lipid levels will return to pretreatment levels.
- Medication is a supplement to diet therapy and exercise.
- If they have any muscle aches or pain, they should contact their provider.
- All of the above
- All of the above
Omega 3 fatty acids are best used to help treat:
- High HDL
- Low LDL
- High triglycerides
- Any high lipid value
- High triglycerides
Which the following persons should not have a statin medication ordered?
- Someone with 3 first- or second-degree family members with history of muscle issues when started on statins
- Someone with high lipids, but low BMI
- Premenopausal woman with recent history of hysterectomy
- Prediabetic male with known metabolic syndrome
- Someone with 3 first- or second-degree family members with history of muscle issues when started on statins