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WorksheetsDR. MADRAS CARDIO PART 1 EXAM 2
Total questions: 67
Worksheet time: 2hrs 18mins
Which of the following are the causes of reduced HDL? Select all that apply
Smoking
Obesity
Sedentary lifestyle
Beta-blockers
Which of the following makes HDL increase? Select all that apply
Smoking cessation
Moderate alcohol ingestion (< 2 drinks/day)
Physical exercise
Weight loss
Oral contraceptives and Phenytoin
Which of the following lipoproteins is secreted by the liver?
VLDL
HDL
IDL
LDL
Which of the following drugs can cause Hypercholesterolemia e Hypertriglyceridemia? Select all that apply
Thiazides
Cyclosporine
Glucocorticoids,
Sirolimus
Beta Bllockers
Which of the following can cause Hypocholesterolemia? Select all that apply
Malabsorption
AIDS
Malnutrition
Chronic liver disease
Rosiglitazone
Which of the following can cause Hypercholesterolemia and Low HDL? Select all that apply
Isotretinoin
Rosiglitazone
Which of the following inhibit intestinal absorption of dietary & biliary CHO?
Benecol (plant stanol-saturated form of plant sterols) and Take Charge (plant sterols)
Lipochol
Which of the following decrease beta-carotene absorption?
Stanol
Sterol
Benecol
Which of the following decrease absorption of alpha and beta carotene, vitamin E?
Stanol
Sterol
Benecol
Which of the following should the patient avoid if has sitosterolemia? Select all that apply
Benecol
Stanol
Sterol
Plant Sterols/Stanols
Which of the following drug class inhibits exogenous pathway and bind bile acids in intestine?
HMG-CoA reductase inhibitors
Bile acid sequestrants
Fibrates
Ezetimibe (Zetia®)
Which of the following drugs reduce LDL and improve glycemic control in type 2 DM adult pts?
Colestipol
Cholestyramine
Colesevelam
Bile Acid Sequestrans
Bile acid sequestrants can cause which of the following?
headache
constipation
migraine
fever
Bile acid sequestrants must be mixed with water, non-carbonated beverage (ex: apple juice, grape juice, pulpy juice-orange juice)
True
False
Which of the following drugs is powder from packet with water or non-carbonated liquid): do not sip or keep in mouth for long time® may cause tooth discoloration and enamel decay
Cholestyramine suspension
Periogard
In Colesevelam adverse effects occur less often but large tablets.
True
False
Bile sequestrants decrease the absorption of which of the following medications? Select all that apply
Warfarin
Niacin
Digoxin
Acetaminophen
Which of the following statements are TRUE about Bile acid sequestrants? Select all that apply
Administer medications at least 1-4 hours before or 4-6 hours after
bile acid sequestrant (medication specific)
can cause Constipation
decrease absorption of medications (ex: warfarin, niacin, digoxin, etc)
Mix with water, non-carbonated beverage (ex: apple juice, grape juice, pulpy
juice-orange juice)
decrease LDL
Other medications must be administered 4 hours prior to Colesevelam.
True
False
Which of the following drugs class Inhibit HMG CoA reductase (endogenous pathway)?
Bile acid sequestrants
Statins
Which of the following statins is reduced VLDL secretion from liver? Select all that apply
Atorvastatin
Fluvastatin
Pravastatin
Rosuvastatin
Which of the following statins have a short half life and must be taken taken in evening (PM) ?
Fluvastatin
Lovastatin
Pravastatin
Simvastatin
Which of the following statins can be taken anytime of day? Select all that apply
Fluvastatin XL
Atorvastatin
Pitavastatin
Rosuvastatin
Pravastatin
Lovastatin IR must be taken
with food (evening meal) to increase bioavailability
taken in evening at bedtime (HS)
Lovastatin ER must be taken
taken in evening at bedtime (HS)
food (evening meal) to increase bioavailability
Statins maximum effect is seen in how many weeks?
2 weeks
6 weeks
8 weeks
3 weeks
Which statins are more hydrophilic?
Pravastatin and Rosuvastatin
Atorvastatin and Rosuvastatin
Which of the following statins should be used in renal impairment, cyclosporine, Asians, etc)?
Rosuvastatin 40mg
Atorvastatin 80 mg
Atorvastatin 20 mg
Rosuvastatin 5mg
Simvastatin 80 mg increases muscle injury or myopathy.
True
False
Know this
True
False
Pitavastatin not indicated to reduce CV morbidity & mortality.
True
False
Fluvastatin and Atorvastatin NO adjustment needed in renal impairment? Select all that apply
Fluvastatin
Rosuvastatin
Atorvastatin
Pravastatin
Which of the following are TRUE about Rosuvastatin? Select all that apply
Primary Prevention of CVD
Reduce risk of stroke
Reduce risk of MI
Reduce risk of arterial revascularization procedures
Liver enzyme tests (ALT, AST) before initiating statin and as clinically indicated
thereafter
True
False
Statins (Select all that apply)
Increase in blood glucose reported
may cause Dyspepsia
Avoid gemfibrozil, Niacin, CYP 3A4 inhibitors
Causes Myalgia
Myopathy/rhabdomyolysis
Gemfibrozil inhibits glucuronidation or preventing renal clearance of statins and
increases statin levels
True
False
Which of the following causes increase risk of Myotoxicity? Select all that apply
Female
Combination regimens (statin, slow release niacin, fibrates, gemfibrozil
Use with CYP inhibitors or substrates (cyclosporine, azole antifungals,
erythromycin, amiodarone
Low BMI
Hypothyroidism
Know this
Yes
No
ACC/AHA/ADA 2018 Lipid Guidelines: baseline, 4-12 weeks after starting or
adjusting statin dose, and then every 3-12 months
True
False
Know this
Yes
No
If I need to take Erythromycin, I need to DISCONTINUE the STATIN during this period and RESTART AFTER completion of the medication.
True
False
If I need to take Cyclosporine on long term basis, I need to use lowest effective statin dose, use statin with least interactions.
True
False
If patient taking Warfarin which of the following STATINS Increase the effect of Warfarin?
Lovastatin
Simvastatin
Rosuvastatin
Gemfibrozil
Take aluminum and magnesium hydroxide combination antacid at least 2 hours after Rosuvastatin.
True
False
Know this
Yes
No
Know this
Yes
No
Know this
Yes
No
Pitavastatin will have drug interactions with which of the following? Select all that apply
Gemfibrozil
Niacin
Colchicine
Fibrates
Statins are contraindicated for ? Select all that apply
Active liver disease
Unexplained, persistent elevation of LFTs
Lactation
None of them are correct
Which of the following are TRUE about Bempedoic Acid (Nexletol)? Select all that apply
adjunct to diet and maximum tolerated statin in adults with heterozygous familial hypercholesterolemia or ASCVD who need to decrease LDL
Adenosine triphosphate-citrate lyase (ACL) inhibitor
Decrease LDL
Causes hyperuricemia, back pain, abdominal pain/discomfort, bronchitis, extremity pain, anemia, increased LFTs, tendon rupture, BPH
Effect on CV morbidity and mortality not known
While taking Bempedoic Acid (Nexletol), I must monitor the lipid panels within:
8-12 weeks
16-20 weeks
While taking Bempedoic Acid, myopathy risk increases with use of simvastatin or pravastatin.
True
False
Which of the following stimulates PPAR alpha receptors?
Fibrates
Bile acid sequestrants
HMG-COA reductase inhibitors
Gemfibrozil: decreases CV events in secondary prevention, BUT NOT to reduce CV mortality.
True
False
Which of the following are some adverse effects for Fibrates? Select all that apply
gynecomastia
rhabdomyolysis
gallstones
thrombocytopenia (monitor CBC)
Myopathy, myalgia, myositis
Which of the following are the contraindications for Fibrates? Select all that apply
Gallbladder disease
Hepatic disease
Primary biliary cirrhosis
Renal disease
Nursing mothers
Which of the following is the MOA for Zetia (Ezetimibe) besides cholesterol absorption inhibitor?
Adenosine triphosphate-citrate lyase (ACL) inhibitor
Inhibits transport of dietary & biliary CHO across intestinal wall
Which of the following are TRUE about Zetia (Ezetimibe)? Select all that apply
Inhibits transport of dietary & biliary CHO across intestinal wall
Cholesterol absorption inhibitor
acts at brush border of small intestine
decreases LDL in combination with statin
Inhibits exogenous pathway
Which of the following are TRUE about Zetia (Ezetimibe)? Select all that apply
Adverse effects like fatigue, angioedema, gallstones, pancreatitis, depression
Not an inhibitor or inducer CYP450
Contraindicated in active liver disease or persistently elevated liver enzymes
Combined with statin: reports of hepatitis
Which of the following is the MOA for Nicotinic Acid?
Inhibits transport of dietary & biliary CHO across intestinal wall
decreases mobilization of FFA from peripheral adipose tissue to liver
On Nicotinic acid Do NOT recommend IR products (dietary supplement and RX): more flushing.
True
False
On Nicotinic acid Do NOT recommend SR products (dietary supplement and RX)
increases hepatoxicity
more flushing
Niaspan ER better than Nicotinic Acid as an option because less hepatoxicity and fewer dermatologic reactions.
True
False
On Nicotinic Acid adverse effects Flushing (tolerance could develop): prostaglandin mediated. Which of the following are TRUE about it? Select all that apply
Avoid drinking hot liquids at time of ingestion
Take up to 325mg ASA 30min before
Avoid hot baths/showers
Take at HS
and Titrate dose slowly
Take with food (do not take on empty stomach)
Yes
No
Nicotinic acid is contraindicated in? Select all that apply
Arterial bleeding
Active liver disease
Active peptic ulcer disease
Niaspan monitoring is serum transaminase levels (including AST and ALT) obtained at baseline, every 6-12 weeks for 1st year
True
False
