Cardio_Dyslipidemia practice questions
Which of the following sign could be the adverse effects of Rosuvastatin A. Severe muscle pain B. Cola-colored urine C. Birth defect D. A and B E. All of the above
E
A patient is started on therapy with niacin. Which one of the following side effects could happen to him during the treatment? A. Face flushing B. Serum transaminase elevation C. Myopathy D. A and B E. All of the above
D
A 54-year-old woman presented with angina of the heart. Laboratory assessment of her serum reveals elevated total and LDL cholesterol. The best drug choice for this patient is A. Atorvastatin B. Gemfibrozil C. Icosapent Ethyl D. Niacin E. None of the above
A
A patient with heterozygous familial hypercholesterolemia is starting on alirocumab. The major mechanism of lowering LDL-C in alirocumab therapy is A. Blockade of PSCK9 B. Inhibition of HMG-CoA reductase C. Stimulation of LPL D. Inhibition of Apo B-100 expression E. Blockade of MTP
A
As compared with lovastatin, Rosuvastatin A. Has a longer half-life B. More lipophilic C. More likely metabolized by CYP3A4 D. Less likely to be used for hypercholesterolemia E. More likely to be given in the evening.
A
The major adverse effect of statins: A. Myopathy B. Cholelithiasis C. Activating gout D. Hypoglycemia E. None of the above
A
The major recognized mechanism of action of ezetimibe is A. Inhibition of NPC1L1-mediated cholesterol absorption B. Inhibition of MTP-mediated VLDL assembly C. Inhibition of cholesterol synthesis D. Stimulation of conversion cholesterol to bile acid E. Stimulation of cholesterol metabolism
A
Which category of drug therapy can raise HDL the most? A. Niacin B. Fibrates C. Bile acid binding resins D. Statins E. Cholesterol absorption inhibitor
A
Which one of the following drugs decreases triglycerides by PPARα-mediated increases in fatty acid oxidation, lipoprotein lipase synthesis, and Apo C expression? A. Fenofibrate B. Niacin C. Cholestyramine D. Lovastatin E. Ezetimibe
A
The major recognized mechanism of action of Gemfibrozil is A. Activation of PPAR B. Activation of PSCK9 C. Inhibition of LPL D. Inhibition of MTP E. Inhibition of NPC1L1
A. Activation of PPAR
The merit of combined drug therapy using colestipol and niacin for hyperlipidemia is A. Colestipol increases triglyceride synthesis, the effect that is buffered by niacin. B. Niacin increases triglyceride, the effect that is buffered by colestipol. C. Synergistic effect on lowing triglyceride because both drugs reduce triglyceride synthesis D. A and C E. B and C
A. Colestipol increases triglyceride synthesis, the effect that is buffered by niacin.
The major mechanism of action of colesevelam is: A. Increased excretion of bile acid salts B. Decreased expression of LDL receptors C. Increased lipid hydrolysis by lipoprotein lipase D. Decreased secretion of VLDL by the liver E. Decreased endogenous synthesis of cholesterol
A. Increased excretion of bile acid salts
Which one of the following drugs causes a decrease in liver triacylglycerol synthesis by limiting available free fatty acids needed as building blocks for this pathway? A. Niacin B. Fenofibrate C. Cholestyramine D. Ezetimibe E. Lovastatin
A. Niacin
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 upstairs 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. Q2. 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
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. Q1. 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 E. Niacin
B
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. Q4. When used as monotherapy, major toxicity of gemfibrozil is increased risk of A. Bloating and constipation B. Cholelithiasis C. Hyperuricemia D. Liver damage E. Severe cardiac arrhythmia
B
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. Q2. Which one of the following is the most common side effect of antihyperlipidemic drug therapy? A. Elevated blood pressure B. Gastrointestinal disturbance C. Neurologic problems D. Heart palpitations E. Migraine Headaches
B
A patient has elevated serum triglyceride and reduced HDL, suffering from gout. Which of the following drug could be selected to treat both conditions? A. Niacin B. Fenofibrate C. Lovastatin D. Cholestyramine E. Ezetimibe
B
A patient is prescribed niacin to reduce his/her triglyceride and LDL-C levels. The side effect(s) of niacin that most commonly limits patient compliance include A. Bloating. B. Flushing and dyspepsia. C. Tinnitus. D. Dry cough. E. Chills.
B
The following statement regarding fibrate drugs are all correct, EXCEPT A. The drugs of choice for treating hypertriglyceridemia B. The therapeutic action on hypertriglyceridemia is mediated by blockade of PPAR C. Can elevate HDL levels D. Major adverse effects include myopathy and cholelithiasis E.Most of drugs are excreted in the urine.
B
When used as monotherapy, the most common and severe toxicity of niacin is A. Cholelithiasis B. Hepatotoxicity C. Myopathy D. Reduced aminotransaminase E. Bleeding
B
Which of the following drug is most likely to cause an increase in the patient's triglyceride when used as monotherapy? A. Atorvastatin B. Cholestyramine C. Ezetimibe D. Gemfibrozil E. Niacin
B. Cholestyramine
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. Q3. 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 lipoprotein lipase D. Inhibition of secretion of VLDL by the liver E. Reduced uptake of dietary cholesterol
C
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. Q5. 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
A patient taking digoxin for his heart failure is started on lovastatin and cholestyramine to lower his/her LDL-C levels. The dose of digoxin A. Should be increased. B. Should be decreased. C. Should be taken 1 hour before or 3 to 4 hours after a dose of cholestyramine. D. Should be eliminated to prevent serious drug interactions. E. Will not be affected as there are no known drug interactions among these drugs.
C
Familial hypercholesterolemia is caused by which of the following gene deficit: A. Lipoprotein lipase B. Niemann-Pick type C protein C. LDL receptor D. LP(a) lipoprotein E. Microsomal triglyceride transfer protein
C
The major recognized mechanism of action of ezetimibe is A. Decreased lipid synthesis in adipose tissue B. Deceased secretion of VLDL by the liver C. Decreased gastrointestinal absorption of cholesterol D. Increased endocytosis of HDL by the liver E. Increased lipid hydrolysis by lipoprotein lipase
C
During atorvastatin therapy, it is important to routinely monitor serum concentration of A. Glucose B. Uric acid C. Creatine phosphokinase D. Platelet E. Blood urea nitrogen
C. Creatine phosphokinase
A 60-year-old man with a history of a mild myocardial infarction was discovered to have low serum HDL-C and moderately high serum triglyceride level. His serum total and LDL cholesterol concentrations were well below the upper limit of normal. The drug that is likely to result in the greatest lowering of this patient's serum triglyceride concentration and elevation of his serum HDL cholesterol concentration is A. Cholestyramine B. Ezetimibe C. Gemfibrozil D. Lovastatin E. Colesevelam
C. Gemfibrozil
Reverse cholesterol transportation is related with A. Chylomicron B. LDL C. HDL D. Prolipoprotein E. VLDL
C. HDL
A 54-year-old woman presented with angina. Laboratory assessment of her serum revealed elevated total and LDL cholesterol. The patient was placed on atorvastatin. This drug lowers serum cholesterol by A. Activating endothelial cell-associated lipoprotein lipase B. Increasing the shunting of hepatic cholesterol into the biochemical pathway of bile acid synthesis C. Indirectly increasing hepatic production of LDL receptors D. Directly increasing hepatic synthesis of VLDL lipoproteins E. Inhibiting the uptake of cholesterol in epithelial cells that line the small intestine
C. Indirectly increasing hepatic production of LDL receptors
Which of the following drug is the best choice for a pregnant woman with increased cholesterol levels? A. Niacin B. Fenofibrate C. Cholestyramine D. Ezetimibe E. Lovastatin
C. cholestryamide
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 upstairs 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. Q1. 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
A patient is prescribed fenofibrate as part of his therapy to raise his/her HDL-C levels. Fenofibrate most likely acts by Selected Answer: A. Inhibiting HMG-CoA reductase. B. Binding cell membrane receptors that leads to lowering of adipocyte hormone-sensitive lipase activity. C. Sequestering bile acids in the small intestine. D. Binding PPARα receptors in liver and adipose tissue. E. Inhibiting cholesterol uptake from the small intestine.
D
Combination therapy with gemfibrozil and rosuvastatin increases the risk of myopathy due to A. Gemfibrozil inhibits hepatic uptake of rosuvastatin, causing rosuvastatin-induced toxicity B. Rosuvastatin inhibits hepatic uptake of gemfibrozil, causing gemfibrozil-induced toxicity C. Gemfibrozil inhibits hepatic metabolize of rosuvastatin, causing rosuvatatin-induced toxicity D. A and C E. All of the above
D
Statins lower LDL-C and total cholesterol by inhibition of cholesterol synthesis in the hepatic cells. Which one of the following statins is lactone prodrug? A. Simvastatin B. Lovastatin C. Atorvastatin D. A and B E. All of the above
D
To prevent Niacin-induced toxicity, which of the following blood test should be taken? A. Plasma transaminase B. Uric acid C. Creatine phosphokinase D. A and B E. All of the above
D
When used as monotherapy, the common adverse effects of gemfibrozil include A. Myopathy B. Lithogenicity C. Reduced alanine aminotransferase D. A and B E. All of the above
D
Which one of the following has the mechanism of action of upregulating LDL receptors and interfering with the synthesis of cholesterol? A. Niacin B. Fibrates C. Bile acid binding resins D. Statins E. Cholesterol absorption inhibitor
D
The major recognized mechanism of action of Niacin is A. Reduces liver triacylglycerol synthesis by limiting available free fatty acids needed as building blocks for this pathway. B. Inhibits production and secretion of VLDL by inhibition of triglyceride synthesis in the liver. C. Increases endothelial cell-associated lipoprotein lipase. D. A and B E. All of the above
E
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 upstairs 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. Q3. 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 triglyceride
E
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. Q2. 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
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. Q1. 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
A 58-year-old man with a history of hyperlipidemia was treated with a drug. The chart 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? A. Colestipol B. Ezetimible C. Gemfibrozil D. Lovastatin E. Niacin
E
A patient is prescribed lovastatin to lower total cholesterol and LDL-C. For maximal effect, he should take his medication A. Before breakfast. B. With breakfast. C. An hour after breakfast. D. With his lunch E. With his evening meal.
E
PJ is a 4.5-year-old boy. At his checkup, the pediatrician notices cutaneous xanthomas and orders a lipid panel. Repeated measures confirm that the patient's serum cholesterol levels are high (936 mg/dL). Further testing confirms a diagnosis of heterozygous familial hypercholesterolemia. Which of the following interventions will be least effective in this patient? A. Atorvastatin B. Ezetimibe C. Lomitapide D. Mipomersen E. Gemfibrozil
E
Statins are the most tolerated and popularly used antihyperlipidemic drugs. However, myopathy could happen during statin therapy, and that is characterized by A. Elevated plasma creatine kinase B. Muscle pain C. Elevated plasma myoglobin levels (myoglobinuria, dark urine color) D. A and B E. All of the above
E
Which of the following blood tests should be taken to monitor the possible adverse effects induced by niacin? A. AST or ALT B. Fasting glucose test C. Uric acid test D. A and B E. All of the above
E
Which of the following statement regarding atorvastatin is incorrect? A. Inhibits HMG-CoA reductase B. Reduces cholesterol synthesis in the liver. C. Increases hepatic production of LDL receptors D. Increases LDL-C uptake in liver E. Inhibits the uptake of cholesterol in epithelial cells that line the small intestine
E. Inhibits the uptake of cholesterol in epithelial cells that line the small intestine
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. Lovastatin B. Mipomersen C. Alicocumab D. Ezetimibe E. Niacin
E. Niacin
Which one of the following drugs reduces VLDL assembly and secretion in the liver by inhibition of microsomal triglyceride transfer protein? - Icosapent Ethyl - Gemfibrozil - Ezetimibe - Lomitapide - Niacin
Lomitapide