Dyslipidemia

Question 1

High cholesterol is a major risk factor for

Answer 1

Coronary heart disease

Question 2

Lipid categories

Answer 2

Cholesterol
Cholesterol esters
TGs
Phospholipids

Question 3

Lipoproteins

Answer 3

LDLs
HDLs
VLDLs

Question 4

Apolipoproteins

Answer 4

ApoB
ApoA1
ApoCIII

Question 5

Pathogenesis of atherosclerosis

Answer 5

Endothelial injury
Inflammatory response
Macrophage infiltration
Platelet adhesion
Smooth muscle cell proliferation
Extracellular matrix accumulation

Question 6

Dyslipidemia common symptoms

Answer 6

Usually asymptomatic

Question 7

Dyslipidemia severe symptoms

Answer 7

Chest pain, anxiety, SOB, lose consciousness, abdominal pain, sudden death

Question 8

Signs of dyslipidemia

Answer 8

Pancreatitis
Eruptive xanthomas
Increased BP, waist size, BMI

Question 9

Lab presentation of dyslipidemia

Answer 9

Increased:
Non-HDL (LDL, TG, TC)
ApoB
LDL-P
Decreased:
HDL

Question 10

AHA approved non-fasted lipid panel if…

Answer 10

Measuring initial risk
Pt not on lipid lowering tx
Pt doesn’t have family hx of genetic hyperlipidemia
Pt TGs are low

Question 11

FLP includes…

Answer 11

TC
TG
HDL
LDL

Question 12

Friedewald equation

Answer 12

LDL = TC - HDL - TG/5
Not valid if TG > 400

Question 13

Lifestyle management of dyslipidemia

Answer 13

DASH diet, reduce saturated/trans fat, lower sodium, engage in moderate-low intensity workouts, increasing soluble fiber can decrease LDLs

Question 14

Dyslipidemia medication options

Answer 14

Statins
Bile acid resins
Niacin
Cholesterol absorption inhibitors
Fibrates
PCSK9 inhibitors
Inclisiran
Bempedoic acid

Question 15

HMG-CoA reductase inhibitors

Answer 15

Lovastatin
Pravastatin
Pitavastatin
Simvastatin
Fluvastatin
Atorvastatin
Rosuvastatin

Question 16

Lovastatin

Answer 16

Altoprev, Mevacor

Question 17

Pravastatin

Answer 17

Pravachol

Question 18

Pitavastatin

Answer 18

Livalo

Question 19

Simvastatin

Answer 19

Zocor

Question 20

Fluvastatin

Answer 20

Lescol

Question 21

Atorvastatin

Answer 21

Lipitor

Question 22

Rosuvastatin

Answer 22

Crestor

Question 23

Low intensity statins

Answer 23

Simvastatin 10mg
Pravastatin 10-20mg
Lovastatin 20mg
Fluvastatin 20-40mg

Question 24

Moderate intensity statins

Answer 24

Atorvastatin 10-20mg
Rosuvastatin 5-10mg
Simvastatin 20-40mg
Pravastatin 40-80mg
Lovastatin 40-80mg
Fluvastatin 40mg BID
Fluvastatin XL 80mg
Pitavastatin 1-4mgg

Question 25

High intensity statins

Answer 25

Atorvastatin 40-80mg Rosuvastatin 20-40mg

Question 26

Lipophilic statins

Answer 26

Fluvastatin Pitavastatin Lovastatin Simvastatin Atorvastatin

Question 27

Hydrophilic statins

Answer 27

Pravastatin Rosuvastatin

Question 28

Statin contraindications

Answer 28

Pregnancy, breastfeeding, acute liver disease

Question 29

AEs of statins

Answer 29

Muscle myopathy/pain, increased creatine kinase

Question 30

FLPs while using statins

Answer 30

Baseline test 4-12 weeks following tx initiation Every 3-12 months prn

Question 31

Bile acid resins (BARs)

Answer 31

Cholestramine Colestipol Colesevelam

Question 32

Cholestyramine

Answer 32

Questran, Prevalite

Question 33

Colestipol

Answer 33

Colestid

Question 34

Colesevelam

Answer 34

WelChol

Question 35

BAR AEs

Answer 35

Can increase TGs GI side effects Impaired absorption of fat-soluble vitamins

Question 36

BAR may decrease effect of:

Answer 36

Warfarin Digoxin Oral contraceptives Ezetimibe Fibrates

Question 37

Niacin

Answer 37

Niacor, Niaspan, Slo-Niacin

Question 38

AEs of Niacin

Answer 38

Flushing, itching

Question 39

Niacin contrainidications

Answer 39

Hepatic disease Peptic ulcer Arterial hemorrhage

Question 40

Cholesterol absorption inhibitor

Answer 40

Ezetimibe Ezetimibe + simvastatin

Question 41

Ezetimibe

Answer 41

Zetia

Question 42

Ezetimibe + simvastatin

Answer 42

Vytorin

Question 43

Ezetimibe contraindications

Answer 43

Use with statin + hepatic disease Pregnancy/breastfeeding w statin

Question 44

Fibrates AEs

Answer 44

GI effects Rash Dizzy

Question 45

Fibrates contraindications

Answer 45

Hx of gallbladder disease Dialysis Liver disease

Question 46

Fibrates increase levels of:

Answer 46

Statins Ezetimibe Sulfonylureas Warfarin

Question 47

PCSK9 monoclonal antibodies

Answer 47

Alirocumab Ecolocumab

Question 48

Alirocumab

Answer 48

Praluent

Question 49

Evolocumab

Answer 49

Repatha

Question 50

PCSK9 dosing

Answer 50

Injectable dosage form Can be dosing q2-4 weeks

Question 51

PCSK9 should be considered for:

Answer 51

Stable ASCVD High risk/statin intolerance Further reduction of LDL after 1st tx

Question 52

Inclisiran

Answer 52

Leqvio

Question 53

Inclisiran AEs

Answer 53

Inj site reactions UTI URI Diarrhea Bronchitis

Question 54

Inclisiran dosing

Answer 54

Injectable dosage form (prefilled syringe) q6 months -> must be admin by HCP

Question 55

Bempedoic acid

Answer 55

Nexletol, Nexlizet

Question 56

Bempedoid acid AEs

Answer 56

URTI, muscle spasm, risk of tendon rupture Avoid use with simvastatin and pravastatin

Question 57

Red yeast rice

Answer 57

Active ingredient: lovastatin

Question 58

Lomitapide

Answer 58

Juxtapid

Question 59

Lomitapide warnings

Answer 59

BBW: hepatotoxicity Must use REMS program

Question 60

Evinacumab

Answer 60

Evkeeza IV infusion