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Dyslipidemia NAPLEX Review Guide 3e

Total questions: 15

Worksheet time: 8mins

Name
Class
Date
1.

CX is a 62-year-old patient that presents to your pharmacy seeking guidance on an appropriate diet to reduce heart disease risk in a patient with high cholesterol. Which of the following lifestyle changes should be recommended to patients with dyslipidemia?

a)

Increase intake of animal products and low carbohydrate vegetables, and limit grains and fruit

b)

Reduce trans fat and limit saturated fat to <10% of calories

c)

Engage in regular physical activity

d)

Eat one serving per week of fatty fish

2.

CE is a 74-year-old man with a PMH of CHD, stroke, and hypothyroidism. He currently takes aspirin, levothyroxine, and simvastatin and has now been prescribed cholestyramine. What will you discuss with the patient?

a)

Take on an empty stomach once daily.

b)

Mix each dose with at least 12 ounces of juice or soda.

c)

Sip slowly to reduce side effects.

d)

Take other medications at least 1 to 2 hours before or 4 to 6 hours after taking cholestyramine.

3.

CE is a 72-year-old man with no clinical ASCVD, no diabetes, and a 10-year ASCVD risk of 12%. Which of the following is recommended for this patient?

a)

Simvastatin 10 mg daily

b)

Fluvastatin 40 mg daily

c)

Pitavastatin 1 mg daily

d)

Rosuvastatin 10 mg daily

4.

What lipid-lowering medication(s) should be adjusted in a patient with renal impairment?

a)

Atorvastatin

b)

Gemfibrozil

c)

Ezetimibe

d)

Cholestyramine

e)

Niacin

5.

A patient on simvastatin complains of muscle pain, weakness, and cramps since running a marathon this past weekend. His CK is 1760 U/L today (normal range, 50-160) and 280 U/L when checked 3 months ago. His Cr is 1.0 mg/dL. How should you manage this patient

a)

Continue therapy and closely monitor the CK

b)

Stop simvastatin until symptoms and CK improve, then try another statin.

c)

Add coenzyme Q10.

d)

Change simvastatin to ezetimibe.

6.

MJ has a history of subtherapeutic anticoagulation on warfarin (due to poor adherence) until the administration time was changed from evening to morning. The patient also frequently skips meals and takes antacids for reflux. Which of the following statins is optimal for this patient?

a)

Pravastatin

b)

Atorvastatin

c)

Lovastatin

d)

Rosuvastatin

7.

KW is a 53-year-old Asian woman with an LDL-C of 210 mg/dL, HDL-C 56 mg/dL, and TG 182 mg/dL. Her PMH is notable for hypertension with a recent BP of 118/70 mm Hg on lisinopril monotherapy. She is a nonsmoker. Her father died of a myocardial infarction at 58 years of age. Her physician elects to use rosuvastatin and requests a dosing recommendation. Although a high-intensity statin is preferred for most patients with LDL-C >190 mg/dL, what is the most appropriate starting dose for KW considering genetic factors?

a)

5 mg daily

b)

10 mg daily

c)

20 mg daily

d)

40 mg daily

8.

JM is a 64-year-old woman with a PMH of pancreatitis (when TG 2200 mg/dL), uncontrolled gout, severe psoriasis, recurrent infections requiring hospitalization, and lovastatin-associated myopathy. Her current medications include rosuvastatin, prednisone, and allopurinol. Colchicine was also added a few days ago for a gout exacerbation. She reports an anaphylactic reaction after eating seafood in college. Her LDL-C is 96 mg/dL, HDL-C 42 mg/dL, and TG 640 mg/dL. Which of the following is the safest addition to her therapy?

a)

Niacin

b)

Colesevelam

c)

Fish oil

d)

Fenofibrate

9.

Which of the following statin doses may be dispensed to a patient also taking gemfibrozil? Select all that apply.

a)

Rosuvastatin 20 mg

b)

Simvastatin 20 mg

c)

Lovastatin 40 mg

d)

Fluvastatin 40 mg

10.

MM is a 54-year-old woman with a past medical history of unstable angina, hypertension, and diabetes. She smokes two packs of cigarettes daily. Her LDL-C is 120 mg/dL, HDL-C 48 mg/dL, and TG 220 mg/dL. Which of the following therapy is recommended?

a)

Simvastatin 80 mg daily

b)

Atorvastatin 80 mg daily

c)

Pravastatin 20 mg daily

d)

Lovastatin 40 mg daily

11.

What medication or combination is safest to use for a patient with advanced hepatic disease?

a)

Colesevelam

b)

Ezetimibe/simvastatin

c)

Niacin

d)

Gemfibrozil

12.

Select the brand name for lovastatin.

a)

Lescol®

b)

Crestor®

c)

Mevacor®

d)

Zocor®

13.

LE is a 33-year-old woman currently attempting to become pregnant. Her physician decides that benefits of dyslipidemia treatment outweigh fetal risks. Her LDL-C is 240 mg/dL, HDL-C 64 mg/dL, and TG 132 mg/dL. Her PMH includes recent cholelithiasis. What is the most appropriate medication for LE?

a)

Rosuvastatin

b)

Niacin

c)

Colesevelam

d)

Gemfibrozil

e)

Omega-3-acid ethyl esters

14.

JT is a 62-year-old woman with low HDL-C who was prescribed niacin. She did not fill her prescription because of the expense and instead took five 100-mg immediate-release crystalline niacin tablets at bedtime. She complains of flushing and dizziness after the first dose that almost caused her to fall. What is the best recommendation to improve overall tolerability?

a)

Change to a “no-flush” formulation and take 81 mg of aspirin 30 to 60 minutes before each dose.

b)

Start with 100 mg bid after breakfast and supper.

c)

Take with food and a hot liquid.

d)

Change to sustained-release OTC formulation.

15.

CL is a 10-year-old boy with familial hyperlipidemia (FH). His physician wishes to use drug therapy since lifestyle changes have failed. His LDL-C is 320 mg/dL. Which of the following medications would you recommend?

a)

Atorvastatin

b)

Colesevelam

c)

Ezetimibe

d)

Niacin

e)

Fenofibrate