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WorksheetsCardio Rem - Exam 2 - Madras
Total questions: 92
Worksheet time: 46mins
Name
Class
Date
1.
In hyperlipidemia, what does the exogenous pathway do
a)
transport fatty acids and CHO derived from diet
b)
transport fatty acids synthesized in small intestines from gut to liver
c)
delivers CHO and TG from liver to pierpheral cells in fasting state and back to liver
2.
In hyperlipidemia, what does the endogenous pathway do
a)
transport fatty acids and CHO derived from diet
b)
transport fatty acids synthesized in small intestines from gut to liver
c)
delivers CHO and TG from liver to pierpheral cells in fasting state and back to liver
3.
Cholesterol is a precursor to
a)
androgens
b)
estrogens
c)
progesterone
d)
adrenocorticoids
e)
bile acids
4.
Starting from Citrate, how is cholesterol synthesized
a)
citrate, acetyl CoA, HMG CoA, mevalonate, cholesterol
b)
citrate, HMG CoA, acetyl CoA, mevalonate, cholesterol
c)
citrate, acetyl CoA, mevalonate, HMG CoA, cholesterol
d)
citrate, HMG CoA, mevalonate, acetyl CoA, cholesterol
5.
What can hydrolyze triglycerides
a)
lipase enzymes
b)
linoleic acid
c)
ACAT enzyme
d)
liver enzymes
6.
Phospholipids are
a)
hydrophilic
b)
hydrophobic
c)
amphipathic
7.
Phospholipids are used to make
a)
cell membranes
b)
secondary messengers
c)
fatty acids for prostaglandin creation
d)
adrenocorticoids
e)
bile acids
8.
Fatty acids are
a)
stored as triglycerides
b)
a component of membrane phospholipids
c)
primarily absorbed from diet
d)
linoleic acid is important
e)
linolenic acid is important
9.
Which are fat soluble vitamins
a)
Vitamin A
b)
Vitamin D
c)
Vitamin E
d)
Vitamin K
e)
Vitamin C
10.
Which vitamin is used to treat xerosis and blindness
a)
Vitamin A
b)
Vitamin D
c)
Vitamin E
d)
Vitamin K
e)
Vitamin C
11.
Which vitamin is used to treat Ricket's disease, osteomalacia, and hypocalcemia
a)
Vitamin A
b)
Vitamin D
c)
Vitamin E
d)
Vitamin K
e)
Vitamin C
12.
Which vitamin is used to treat erythrocytes fragility and peripheral neuropathy
a)
Vitamin A
b)
Vitamin D
c)
Vitamin E
d)
Vitamin K
e)
Vitamin C
13.
Which vitamin is used to treat bleeding disorders
a)
Vitamin A
b)
Vitamin D
c)
Vitamin E
d)
Vitamin K
e)
Vitamin C
14.
Which type of absorption happens through the intestines
a)
exogenous
b)
endogenous
15.
Which type of absorption happens through enterocytes
a)
exogenous
b)
endogenous
16.
In exogenous absorption of lipids, triglycerides go through pancreatic lipase to turn into diglycerides and monoglycerides before entering endogenous absorption. What can this be inhibited by
a)
Orlistat
b)
Alli
c)
insulin
d)
glucagon
e)
Omega-3
17.
What structures have more triglycerides than cholesterol
a)
chylomicrons
b)
VLDL
c)
HDL
d)
LDL
e)
IDL
18.
Where do fibrates work
a)
chylomicrons
b)
VLDL
c)
HDL
d)
LDL
e)
IDL
19.
Where is the most atherogenic lipoprotein
a)
chylomicrons
b)
VLDL
c)
HDL
d)
LDL
e)
IDL
20.
Where is the main target for lipid-lowering medications
a)
chylomicrons
b)
VLDL
c)
HDL
d)
LDL
e)
IDL
21.
Which structure gets rid of cholesterol
a)
chylomicrons
b)
VLDL
c)
HDL
d)
LDL
e)
IDL
22.
What are we trying to prevent by controling lipid levels
a)
stroke
b)
MI
c)
CV death
d)
asthma
e)
edema
23.
What are some secondary causes of hypercholesterolemia
a)
thiazides, cyclosporine
b)
glucocorticoids
c)
oral estrogens
d)
hypothyroidism
e)
diabetes
24.
What are some secondary causes of hypertriglyceridemia
a)
thiazides, cyclosporine
b)
glucocorticoids
c)
oral estrogens
d)
hypothyroidism
e)
diabetes
25.
How do bile acid sequestrants reduce LDL
a)
they bind to bile acids
b)
they break down bile acids to be digested
c)
they break down bile acids to be secreted in urine<br />
d)
they bind to the precursor of bile acids so it cannot be made<br />
26.
What are some examples of bile acid sequestrants
a)
colestipol
b)
cholestyramine
c)
colesevelam
d)
zetia
e)
nicotinic acid
27.
What will bile acid sequestrants do in the body
a)
decrease LDL
b)
increase LDL
c)
decrease triglycerides
d)
increase triglycerides
e)
increase HDL
28.
Bile acid sequestrants should be avoided if
a)
TG >300 mg/dL
b)
TG <300 mg/dL
c)
LDL >300 mg/dL
d)
LDL <300 mg/dL
29.
What are indications for Colsevelam
a)
reduce LDL
b)
reduce TG
c)
improve glycemic control in T2DM adults
d)
improve BP control in pts with HTN
30.
You can sip or keep cholesytramine suspension in your mouth for a long time
a)
true
b)
false (you cannot sip or keep in mouth for a long time)
31.
How does Colesevelam affect drug absorption of other drugs
a)
decreases binding affinity for other drugs
b)
increases binding affinity for other drugs
c)
does not effect other drugs
32.
How long prior to taking Colesevelam should you take drugs with a known or untested drug interaction prior to taking Colesevelam
a)
1 hr
b)
2 hrs
c)
3 hrs
d)
4 hrs
e)
5 hrs
33.
Which Lovastatin needs to be taken with food
a)
IR
b)
ER
c)
both
d)
neither
34.
Which Lovastatin needs to be taken in the evening at bedtime
a)
IR
b)
ER
c)
both
d)
neither
35.
Which statins have a short half-life and therefore need to be taken in the evening to maximize the decrease in LDL
a)
fluvastatin
b)
lovastatin
c)
pravastatin
d)
simvastatin
e)
fluvastatin XL
36.
Which statin can be taken anytime of the day
a)
fluvastatin
b)
atorvastatin
c)
pitavastatin
d)
rosuvastatin
e)
fluvastatin XL
37.
When is the maximum effect of statins seen
a)
3 wks
b)
4 wks
c)
5 wks
d)
6 wks
38.
What dose of Simvastatin increases muscle injury or myopathy (mainly during the first 12 months)
a)
40 mg
b)
50 mg
c)
60 mg
d)
70 mg
e)
80 mg
39.
What baseline blood test must be performed before starting a statin
a)
ALT
b)
AST
c)
HbA1c
d)
CBC
e)
CMP
40.
What levels will increase after starting a statin
a)
ALT
b)
AST
c)
HbA1c
d)
fasting glucose
e)
bilirubin
41.
If a patient that was started on a statin complains about myalgias, what blood test need to be run
a)
ALT
b)
AST
c)
creatine kinase
d)
uric acid
e)
bilirubin
42.
Gemfibrozil should be administered alongside statins
a)
true
b)
false (should not be administered)
43.
What is a hallmark symptom indiciative of rhabdomyolysis
a)
brown-tinged (cola-colored) urine
b)
green-yellow halos
c)
blue-grey discoloration
d)
yellowing of skin
44.
According to the ACC/AHA/ADA 2018 Lipid Guidelines for Statin Safety and Statin-Associated Side Effects, CoQ 10 is recommended for routine use if taking a statin or to treat statin-associated muscle symptoms
a)
true
b)
false (it is not recommended)
45.
When should a new lipid profile be done after starting someone on or after adjusting a statin dose
a)
6-12 wks
b)
4-12 wks
c)
8-12 wks
d)
3-12 months
e)
6-12 months
46.
Which drugs are contraindicated with simvastatin
a)
ketoconazole
b)
itraconazole
c)
erythromycin
d)
clarithromycin
e)
gemfibrozil
47.
If a patient is on verapamil or diltiazem, what is the maximum dose of simvastatin the patient can be on
a)
10 mg/day
b)
20 mg/day
c)
contraindicated with Simvastatin
d)
30 mg/day
e)
40 mg/day
48.
If a patient is on amiodarone, amlodipine, or ranolazine, what is the maximum dose of simvastatin the patient can be on
a)
10 mg/day
b)
20 mg/day
c)
contraindicated with Simvastatin
d)
30 mg/day
e)
40 mg/day
49.
A patient taking a statin must avoid grapefruit juice
a)
true
b)
false (can drink grapefruit juice)
50.
Which drugs are contraindicated with Lovastatin ER
a)
ketoconazole
b)
itraconazole
c)
erythromycin
d)
clarithromycin
e)
nefazodone
51.
Which drugs should be avoided with Lovastatin ER
a)
cyclosporine
b)
gemfibrozil
c)
verapamil
d)
diltiazem
e)
dronedarone
52.
If a patient is on danazol, diltiazem, dronedarone, or verapamil, what is the maximum dose of Lovastatin ER the patient can be on
a)
10 mg/day
b)
20 mg/day
c)
contraindicated with Lovastatin ER
d)
30 mg/day
e)
40 mg/day
53.
If a patient is on amiodarone, what is the maximum dose of Lovastatin ER the patient can be on
a)
10 mg/day
b)
20 mg/day
c)
contraindicated with Lovastatin ER
d)
30 mg/day
e)
40 mg/day
54.
Which drugs should be avoided with Atorvastatin
a)
cyclosporine
b)
tipranavir plus ritonavir
c)
glecaprevair plus pibrentasvir
d)
clarithromycin
e)
itraconazole
55.
What is the maximum daily dose of atorvastatin if a patient is on clarithromycin or itraconazole
a)
10 mg/day
b)
20 mg/day
c)
30 mg/day
d)
40 mg/day
56.
What is the maximum daily dose of atorvastatin if a patient is on nelfinavir
a)
10 mg/day
b)
20 mg/day
c)
30 mg/day
d)
40 mg/day
57.
Pitavastatin should be taken at a different time than Gemfibrozil
a)
true
b)
false (can be taken together)
58.
What are some other contraindications for statin use
a)
active liver disease
b)
unexplained persistent elevation of LFTs
c)
lacation
d)
myalgias
59.
What is the main effect of Bempedoic Acid (Nexletol)
a)
decrease LDL
b)
decrease TG
c)
increase HDL
60.
What are some characteristics of Bempedoic Acid (Nexletol)
a)
effect on CV morbidity and mortality not known
b)
ACL inhibitor
c)
check lipid panel within 8-12 wks after starting
d)
avoid with doses >20 mg of simvastatin
e)
avoid with doses >40 mg of pravastatin
61.
What are some adverse effects of Bempedoic Acid (Nexletol)
a)
hyperuricemia
b)
increased LFTs
c)
tendon rupture<br />
d)
increase CV morbidity/mortality
62.
What is the main effect of Fibrates
a)
decrease LDL
b)
decrease TG
c)
increase HDL
63.
What are some adverse effects of Fibrates
a)
anemia
b)
gallstones
c)
thrombocytopenia
d)
leukopenia
64.
What are contraindications for fibrates
a)
gallbladder disease
b)
hepatic disease
c)
renal disease
d)
myalgias
65.
Fibrates interact with Warfarin and can increase INR
a)
true
b)
false (does not interact)
66.
What is the main effect of Ezetimibe (Zetia)
a)
decrease LDL
b)
decrease TG
c)
increase HDL
67.
What are the contraindications for Ezetimibe (Zetia)
a)
active liver disease
b)
persistently elevated LFTs
c)
active kidney disease
d)
CAD
68.
What does immediate release nicotinic acid cause more of
a)
hepatotoxicity
b)
flushing
c)
in between
69.
What does sustained release nicotinic acid cause more of
a)
hepatotoxicity
b)
flushing
c)
in between
70.
What does extended release nicotinic acid (Niaspan) cause more of
a)
hepatotoxicity
b)
flushing
c)
in between
71.
What are the effects of Nicotinic Acid
a)
decrease LDL
b)
decrease TG
c)
increase HDL
72.
What are some adverse effects of Nicotinic Acid
a)
flushing
b)
itching
c)
hyperglycemia
d)
hyperuricemia
73.
If a patient is experiencing flushing from Nicotinic Acid, what can they take
a)
aspirin
b)
tylenol
74.
What is a boxed warning for Lomitapide (Juxtapid)
a)
hepatotoxicity
b)
increase transaminases
c)
increases hepatic fat
75.
What are some contraindications of Nicotinic Acid
a)
active liver disease
b)
active peptic ulcer disease
c)
arterial bleeding
d)
active kidney disease
e)
CAD
76.
PCSK9 inhibitors have cardiovascular benefits
a)
true
b)
false (do not have benefits)
77.
What drugs are PCSK9 inhibitors
a)
Alirocumab (Praluent)
b)
Evolocumab (Repatha)
c)
Inclisiran (Leqvio)
d)
Lomitapide (Juxtapid)
78.
Which drugs are administered subcutaneously
a)
Alirocumab (Praluent)
b)
Evolocumab (Repatha)
c)
Inclisiran (Leqvio)
d)
Lomitapide (Juxtapid)
79.
Vitamin E and C are recommended for cardiac protection
a)
true
b)
false (not recommended)
80.
What is the LDL lowering goal for a patient taking a high intensity statin
a)
greater than or equal to 50%
b)
30-49%
c)
less than 30%
81.
What is the LDL lowering goal for a patient taking a moderate intensity statin
a)
greater than or equal to 50%
b)
30-49%
c)
less than 30%
82.
What is the LDL lowering goal for a patient taking a low intensity statin
a)
greater than or equal to 50%
b)
30-49%
c)
less than 30%
83.
What are the high intensity statins
a)
Atorvastatin 80 mg
b)
Rosuvastatin 20 mg
c)
Atorvastatin 10 mg
d)
Rosuvastatin 10 mg
e)
Pravastatin 40 mg
84.
What are the low intensity statins
a)
Pravastatin 10-20 mg
b)
Lovastatin 20 mg
c)
Lovastatin 40 mg
d)
Pravastatin 40 mg
e)
Fluvastatin 40 mg
85.
According to the ACC/AHA Lipid Guidelines, what are the different statin groups
a)
secondary ASCVD prevention
b)
severe hypercholesterolemia (LDL greater than or eq to 190 mg/dL)
c)
primary prevention: adults 40-75 YO w DM and NO ASCVD AND LDL greater than or eq to 70 mg/dL
d)
primary prevention: adults 40-75 YO AND LDL 70-189 mg/dL AND NO DM AND NO ASCVD AND greater than or eq to 7.5% 10-year ASCVD risk
86.
A patient with a hx of ___ would be someone with ASCVD
a)
ACS
b)
MI, PAD including aortic aneurysm
c)
stable or unstable angina
d)
coronary or other arterial revascularization
e)
stroke, TIA
87.
If a pt on a high intensity statin AND ezetimibe and are not meeting their LDL goal, what should be started
a)
PCSK9
b)
aspirin
c)
another statin
d)
warfarin
88.
If a patient is 20-75 YO and has an LDL of greater than or equal to 190 mg/dL, what should they be started on
a)
high intensity statin
b)
moderate intensity statin
c)
low intensity statin
d)
ezetimibe
e)
PCSK9
89.
If a patient 40-75 YO with DM and LDL greater than or equal to 70, what should they be started on
a)
high intensity statin
b)
moderate intensity statin
c)
low intensity statin
d)
ezetimibe
e)
PCSK9
90.
If a patient is 50-75 with DM, what should they be started on
a)
high intensity statin
b)
moderate intensity statin
c)
low intensity statin
d)
ezetimibe
e)
PCSK9
91.
Adults with DM at high risk should have an ASCVD score calculated and if the risk is greater than or equal to 20%, the pt should be started on a moderate intensity statin
a)
true
b)
false (low intensity statin)
c)
false (high intensity statin)
92.
If a patient has a ASCVD risk score of 7.5%, what should they be started on
a)
high intensity statin
b)
moderate intensity statin
c)
low intensity statin
d)
ezetimibe
e)
PCSK9
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