Cardio Chapter 4 Self-Test Questions (Exam 2)

After being counseled about lifestyle and dietary changes, the patient was started on atorvastatin. During his treatment with atorvastatin, it is important to routinely monitor serum concentrations of A. Blood urea nitrogen B. Alanine and aspartate aminotransferase C. Platelets d. Red blood cells E. Uric acid

B. Alanine and aspartate aminotransferase (Monitor liver function. Also monitor creatine kinase levels due to myopathy caused by statins)

When used as monotherapy, a major toxicity of gemfibrozil is increased risk of... A. Bloating and constipation B. Cholelithiasis C. Hyperuricemia D. Liver damage E. Severe cardiac arrhythmia

B. Cholelithiasis (2 major adverse effects of gemfibrozil. 1) rhabdomyolysis and 2) gallstones)

A 43-year-old woman appears to have familial combined hyperlipidemia. Her serum concentrations of total cholesterol, LDL cholesterol, and triglyceride are elevated. Her serum concentration of HDL cholesterol is somewhat reduced. Which of the following drug is most likely to cause an increase in this patient's triglyceride when used as monotherapy? a. Atorvastatin b. cholestyramine c. ezetimibe d. gemfibrozil

B. Cholestyramine

Which of the following is the most common side effects of antihyperlipidemic drug therapy? A. Elevated blood pressure B. Gastrointestinal disturbance C. Neurologic problems D. Heart palpitations E. Migraine headaches

B. Gastrointestinal disturbance

The patient is starting on gemfibrozil. The major mechanism of action of gemfibrozil is: A. Increased excretion of bile acid salts. B. Reduced expression of high-affinity LDL receptors C. Increased lipid hydrolysis by liporotein lipase D. Inhibition of secretion of VLDL by the liver E. Reduced uptake of dietary cholesterol

C. Increased lipid hydrolysis by liporotein lipase (LPL is on vasculature and is responsible for transferring TG from plasma to tissues)

If the patient's symptoms are caused by an inherited disorder, familial hypercholesterolemia. this disease is caused by which of the following gene deficit: a. lipoprotein lipase b. niemann-pick type C protein c. LDL receptor d. HDL receptor e. microsomal triglyceride transfer protein

C. LDL receptor

A 43-year-old man has heterozygous familial hypercholesterolemia. His serum concentrations of total cholesterol and LDL are markedly elevated. His serum concentration of HDL cholesterol, VLDL cholesterol, and triglyceride are normal or slightly elevated. The patient mother and older brother died of myocardial infarction before the age of 50. This patient recently experienced mild chest pain when walking up stairs and has been diagnosed as having angina. The patient is somewhat overweight. He drinks alcohol most evening and smokes about a pack of cigarettes per week. If the patient has a history of gout, which of the following drugs is most likely to exacerbate this condition? A. Colestipol B. Ezetimibe C. Gemfibrozil D. Niacin E. Simvastatin

D. Niacin (Have to monitor 3 medical conditions with niacin: 1. Gout 2. Glucose 3. Peptic ulcer disease)

A 44-year-old obese man has extremely high plasma triglyceride levels, but cholesterol levels are within normal limits. Following treatment with a drug specifically indicated for hypertriglyceridemia, triglyceride levels decrease to almost normal. Which of the following agents is most likely to have caused this desired change? A. Atorvastatin B. Cholestyramine C. Colestipol D. Ezetimibe E. Gemfibrozil

E. Gemfibrozil

Consumption of alcohol is associated with which of the following changes in serum lipid concentrations? A. Decreased chylomicrons B. Decreased HDL cholesterol C. Decreased VLDL cholesterol D. Increased LDL cholesterol E. Increased triglycerides

E. Increased triglycerides (Cause pancreattis)

A 58-year-old man with a history of hyperlipidemia was treated with a drug. The chat below shows the results of the patients fasting lipid panel before treatment and 6 mo after initiating drug therapy. Normal values are also shown. Which of the following drugs is most likely to be the one that this man received? (HDL increased by 50%) A. Colestipol B. Ezetimibe C. Gemfirbozil D. Lovastatin E. Niacin

E. Niacin (Gemfibrozil could also increase HDL, but it's not as effective as niacin)

If this patient is pregnant, which of the following drugs should be avoided because of a risk of harming fetus A. Cholestyramine B. Ezetimibe C. Fenofibrate D. Niacin E. Pravastatin

E. Pravastatin (Risk category D, all others category C)