Macrophages oxidize LDL-cholesterol and lead to what type of formation that clogs artery?

What kind of bonds to Saturated fatty acids have?

A fatty acid labeled 16:0 would be what type of fatty acid

Unsaturated fatty acids have which types of bonds and show up as what type of number symbol?

Omega-6 fatty acids have the first double bonds 6 Carbons away from the alpha carbon, and Omega 3 has the first double bond 3 carbons away. Oxidized LDL can make these chains very susceptible to attack from what?

Which of the following are effects from the formation of lipid peroxide formation from LDL oxidation with ROS

Which of the following decreased risk of cardiovascular disease in diet studies?

Triglycerides are formed by glycerol and fatty acids, under which lipolysis will yield glycerol and convert to what?

True or False: We consume more cholesterol in our diet than we do producing it in biosynthesis

Which of the following are important roles of cholesterol in our body?

What is the rate limiting step in acetylCoA transformation to form mevalonic acid which is the major molecule to convert to cholesterol?

Bile acids are formed from cholesterol in the ________ and are metabolized by _________

Where do LDL lipoproteins carry lipids?

Where do HDL lipoproteins carry lipids

Which lipoprotein carries the largest amount % of cholesterol?

Which of the following anti-hyperlipidemics reduce lipoprotein production

Nicotinic acid is a precursor to NAD+ found as an electron mitochondrial carrier to the ETC. Niacin activates the niacin receptor which has what effect?

Which of the following are side effects of Niacin?

The AIM-HIGH trial showed what outcomes for using Niacin with a statin

Fibrates are PPARa agonists which are ester prodrugs, what is their type of compound action and acid type?

What is the MOA of Fibrates?

What effects do we see from Fibrate MOA?

Which of the following fibrate drugs increase warfarin levels?

True or False: Gemfibrozil and Fenofibrates can increase bleeding risk and increase tPA production, decrease platelet aggregation, and decrease fibrinogen

Which of the following can increase myalgias and rhabdomyolysis when combined with statins?

MTP is located in the ER of hepatocytes and it increases production of TG lipoproteins like VLDL and chylomicrons. Lomitapide is used to inhibit this protein. What are the net effects?

What does Mipomersen do to ApoB lipoprotein synthesis?

Both Mipomersen and Lomitapide for familial hypercholesterolemia can cause what ADE?

Ezetimibe is a fluorinated compound inhibits cholesterol absorption in the small intestine which what?

Which of the following enhance cholesterol removal?

LDL-c circulating in the blood is taken up by LDL receptors in hepatocytes where which things can happen?

Bile acid sequestrants do what?

Bile acid sequestrants decrease LDL levels by doing what?

Which drugs interact with bile acid sequestrants?

which of the following are natural statins with decaline ring structure?

True or False: All of the synthetic statins have the 3,5-dihydroxy carboxylic acid but do not have the decaline rings of natural statins

True or False: Statins do decrease the production of cholesterol via inhibition of HMG-CoA reductase, but this does not lower LDL from diet but allows for circulating LDL to be continuously excreted

Which of the following are risks in statin use?

Which statin has less protein binding and is less likely to displace warfarin?

Which statins are prodrugs that need to be hydrolyzed to active metabolites?

True or False: Statins increase lipoprotein oxidation but decrease inflammation

True or False: Statins undergo extensive first pass metabolism

Which enzyme levels need to be monitored on Statins?

PCSK9 protease naturally causes degradation of LDL receptors on hepatocyte cell membranes. PCSK9 inhibitors allow for enhanced expression of LDL-receptors. What are the net effects?

What are the clinical aspects of Niacin immediate release

What are some clinical aspects of Niacin ER 8hour tablets?

What are some clinical aspects of Niacin SR 24hr tablets?

True or False: Lovastatin IR release increases bioavailability in the fasted state

Which bile acid sequestrant has dose dependent LDL lowering and less GI side effects than the others?

True or False: Fenofibrate is a lipophilic prodrug undergoing hydrolysis to active Fenofibric acid, it should be taken with food or high fat meal

Which form of fenofibrates has the best bioavailability due to ionization to increase absorption in aqueous GI environments?

Which fenofibrate formulations require food to be eaten?

Which fenofibrate formulations do not require food?

True or False: PCSK9 enzyme is located intracellularly for the monoclonal antibody inhibitors to bind

Which PCSK9 inhibitor has the lowest incidence of patient's developing neutralizing antibodies?

Which fatty acid brand only contains EPA?

You have a patient present with history of MI, PAD, and a CABG surgery. Are you using primary or secondary prevention treatments?

You have a patient present with diabetes, hypertension, and they smoke about one pack of cigarettes per day. They otherwise have unremarkable health history. Are they going to be treated with primary or secondary prevention

Which of the following are modifiable ASCVD risk factors?

If you have a patient with an LDL-c of >190mg/dL but no other risk enhancing factors present, what is the best strategy of treatment?

True or false: The higher the ASCVD risk, the greater the likelihood of benefits of therapy outweighing risks

Which of the following are good lifestyle management changes a patient should do to reduce risk of ASCVD

What are the ABCD'S of primary prevention?

Which patients would not be good candidates for ASA therapy for primary prevention?

True or False: The higher the 10 year ASCVD risk score (>10%) the less ASA net benefit and higher GI bleed rates which is not favorable benefits vs risks

What were the results of the ARRIVE aspirin primary prevention trial?

The ASPREE trial looked at aspirin for primary prevention in adults >70 years old with no history of ASCVD or high risk of bleeding. What were the findings of this?

What medications would primarily target a TG level above 500-1000

True or False: The mediterranean diet was found to significantly reduce risk of primary endpoint of Major CV events compared to normal dietary fats

Losing weight and making dietary changes for cholesterol can reduce the LDL by at least what?

HMG-CoA reductase inhibitors like statins can up-regulate LDL receptors to clear more LDL on top of what other effects?

Which of the following effects do Statins have on total cholesterol?

True or False: Statins are contraindicated in pregnancy, nursing, and active liver disease but rarely cause liver disease

What baseline monitoring should be done prior to starting a statin?

True or False: Rhabdomyolysis is a muscle myopathy/weakness with a CK >10x ULN with an increase in SrCr

If a patient presents with myalgia pain and CK is >10 ULN what is the appropriate strategy?

CoQ10 supplementation can possible reduce muscle pain by statins blocking CoQ10 production but what does it not accomplish in statin myalgias?

What is the threshold of liver transaminase (ALT/AST) elevations to stop a statin

Pulmonary Hypertension is a constriction of the pulmonary arteries, what are the 3 main pathways of this?

What is the most common type of pulmonary hypertension?

Pulmonary arterial hypertension is Group 1, and connective tissue disorders are the most common cause. What are also some drugs that can cause this?

True or False: Dyspnea, edema, and fatigue are symptoms of HFrEF and PAH. If a patient has syncope, would this point more to HFrEF or PAH?

What are some signs of PAH?

How would a Stage 4 Pulmonary Hypertension patient present with symptoms according to activity?

An 6 minute exercise endurance <165meters, Right atrial pressure >14mmHg, and BNP >300ng/l would associate with better or worse prognosis?

What is the Functional Test to officially diagnose PAH?

Which of the following is high and would indicate PAH?

If a patient has a PCWP >15mmHg what is this indicative of?

Calcium Channel blockers would not be considered for treatment for pulmonary hypertension which is?

Which CCBs would be used in pulmonary hypertension for patients with low HR?

Phosphodiesterase inhibitors are used for which functional classes of pulmonary hypertension?

Vasodilator tests are performed first in Pulmonary hypertension to dictate who will respond to CCBs. If a patient does not obtain a decrease in mPAP of >10mmHg and maintain hemodynamics, will they be eligible for CCBs?

Which PDE inhibitor improves exercise capacity, FC, hemodynamics, and also can reduce worsening of FC 2 or 3

SGC Stimulator Riociguat enhances cGMP and increases NO. What is contraindicated?

Riociguat is approved for which FC classes?

Which Endothelin receptor antagonists are ET-A selective?

What are shared side effects of all endothelin receptor antagonists

True or False: Macitentan was the first ERA to show decrease in morbidity and mortality end points

True or False: Prostacyclins have antiplatelet and antiproliferative properties to delay progression of lung disease and increase risk of bleeding

Which prostacyclin drug reduces mortality for FC 3 + 4 PH

Which prostacyclin has a longer half life that has less ADRs related to CADD-legacy pump malfunction but does not reduce mortality

Which Prostacyclin has IV, inhalation, and PO routes but higher risk of gram-negative bloodstream infections

Selexipag is an oral selective IP receptor agonist, reduces mortality and morbidity alone or with ERAs and PDE5i. Are you able to miss doses more than 3 days without retitrating?

Which PH oral treatments have the highest recommendation of use together?

What is a first line agent in FC IV PH