Hyperlipidemia FITZ Flashcards
1
Q
- A 78-year-old woman has hypertension, a
100 pack-year history of cigarette smoking,
peripheral vascular disease, and reduced renal
function (GFR = 47 mL/min/1.73 m2). Triglyceride
level is 280 mg/dL (3.164 mmol/L); high-density
lipoprotein (HDL) level is 48 mg/dL (1 mmol/L);
and low-density lipoprotein (LDL) level is 135 mg/dL
(3.5 mmol/L). Which of the following represents
the most appropriate pharmacologic intervention
for this patient’s lipid disorders?
A. Owing to her age and comorbidity, no further
intervention is required.
B. Moderate-intensity statin therapy is the preferred
treatment option.
C. A resin should be prescribed.
D. The use of ezetimibe (Zetia®) will likely be
sufficient to achieve dyslipidemia control.
A
B. Moderate-intensity statin therapy is the preferred
treatment option.
2
Q
- You examine a 46-year-old male who is a
one-half pack per day cigarette smoker with
hypertension. He has no evidence of clinical
atherosclerotic cardiovascular disease (ASCVD),
and his estimated 10-year ASCVD risk is 10%.
His lipid profile is as follows: HDL level is
48 mg/dL (1.24 mmol/L); LDL level is 192 mg/dL
(4.9 mmol/L); and triglyceride level is 110 mg/dL
(1.3 mmol/L). He had been on a low-cholesterol
diet for 6 months when these tests were taken.
Which of the following represents the best
next step?
A. No further intervention is required.
B. A fibrate should be prescribed.
C. A low-intensity 3-hydroxy-3-methylglutaryl–
coenzyme A (HMG-CoA) reductase inhibitor
should be prescribed.
D. A high-intensity HMG-CoA reductase inhibitor
regimen should be initiated.
A
D. A high-intensity HMG-CoA reductase inhibitor
regimen should be initiated.
3
Q
- You examine a 64-year-old man with hypertension and type 2 DM. Lipid profile results are as follows: HDL
level is 38 mg/dL (1 mmol/), LDL level is 135 mg/dL
(3.5 mmol/L), and triglyceride level is 180 mg/dL
(1.9 mmol/L). His estimated 10-year ASCVD risk is
5%. His current medications include a sulfonylurea,
a biguanide, an angiotensin-converting enzyme
inhibitor, and a thiazide diuretic, and he has acceptable
glycemic and blood pressure control. He states, “I really
watch the fats and sugars in my diet.” Which of the
following is the most appropriate advice?
A. No further intervention is needed.
B. His lipid profile should be repeated in 6 months.
C. Lipid-lowering drug therapy with a moderateintensity
statin should be initiated.
D. The patient’s dietary intervention appears
adequate.
A
C. Lipid-lowering drug therapy with a moderateintensity
statin should be initiated.
4
Q
- When providing care for a patient taking an
HMG-CoA reductase inhibitor, initial evaluation
when starting medication includes checking which
of the following serological parameters?
A. potassium
B. alanine aminotransferase
C. bilirubin
D. alkaline phosphatase
A
B. alanine aminotransferase
5
Q
- When prescribing a fibrate, the NP expects to see
which of the following changes in lipid profile?
A. marked decrease in LDL level
B. increase in HDL level
C. no effect on triglyceride level
D. increase in very low-density lipoprotein (VLDL)
level
A
B. increase in HDL level
6
Q
122. When prescribing niacin, the NP expects to see which of the following changes in lipid profile? A. marked decrease in LDL level B. increase in HDL level C. no effect on triglyceride level D. increase in VLDL level
A
B. increase in HDL level
7
Q
- In prescribing niacin therapy for a patient with
hyperlipidemia, the NP considers that:
A. postdose flushing is often reported.
B. periodic creatine kinase monitoring is warranted.
C. low-dose therapy is usually effective in increasing
LDL level.
D. drug-induced thrombocytopenia is a common
problem.
A
A. postdose flushing is often reported.
8
Q
- With the use of ezetimibe (Zetia®), the NP expects
to see:
A. a marked increase in HDL cholesterol.
B. a reduction in LDL cholesterol.
C. a significant reduction in triglyceride levels.
D. increased rhabdomyolysis when the drug is
used in conjunction with HMG-CoA reductase
inhibitor.
A
B. a reduction in LDL cholesterol.
9
Q
125. With ezetimibe (Zetia®), which of the following should be periodically monitored? A. alkaline phosphatase (ALP) B. lactate dehydrogenase (LDH) C. creatinine phosphokinase (CPK) D. No special laboratory monitoring is recommended.
A
D. No special laboratory monitoring is
recommended.
10
Q
- With the use of a lipid-lowering resin such as
cholestyramine, which of the following enzymes
should be periodically monitored?
A. ALP
B. LDH
C. aspartate aminotransferase (AST)
D. No particular monitoring is recommended.
A
D. No particular monitoring is recommended.
11
Q
- All of the following are risks for statin-induced
myositis except:
A. advanced age.
B. use of a low-intensity statin therapy with a resin.
C. low body weight.
D. high-intensity statin therapy.
A
B. use of a low-intensity statin therapy with a resin.
12
Q
128. What is the average LDL reduction achieved with a change in diet as a single lifestyle modification? A. less than 5% B. 5% to 10% C. 11% to 15% D. 16% to 20% or more
A
B. 5% to 10%
13
Q
- You are seeing a patient who is taking warfarin and cholestyramine and provide the following advice:
A. “Take both medications together.”
B. “You need to have additional hepatic and renal
monitoring tests while on this combination.”
C. “Separate the cholestyramine from other
medications by at least 2 hours.”
D. “Make sure you take these medications on an
empty stomach.”
A
C. “Separate the cholestyramine from other
medications by at least 2 hours.”
14
Q
130. Which of the following medications is representative of high-intensity statin therapy? A. pravastatin 40 mg B. rosuvastatin 20 mg C. simvastatin 40 mg D. lovastatin 20 mg
A
B. rosuvastatin 20 mg
15
Q
131. Which of the following daily doses has the lowest lipid-lowering effect? A. simvastatin 10 mg B. rosuvastatin 5 mg C. atorvastatin 10 mg D. pravastatin 40 mg
A
A. simvastatin 10 mg
