View Exam | PowerPak

1. A 65-year-old patient has clinical ASCVD, hypertension, and diabetes. Fasting lipid panel is: total cholesterol 240 mg/dL, HDL-C 40 mg/dL, LDL-C 150 mg/dL, and triglycerides 250 mg/dL. The patient smokes and is on medication for hypertension and diabetes. According to the 2018 Cholesterol Guideline, which therapy is recommended for this patient?

A. Atorvastatin 20 mg daily B. Evolocumab 140 mg every 2 weeks C. Icosapent ethyl 4 grams daily D. Rosuvastatin 20 mg daily

2. Which of the following lipid-lowering regimens lowers LDL-C levels the most?

A. Alirocumab 150 mg every 2 weeks B. Colesevelam 3.75 grams daily C. Ezetimibe 10 mg daily D. Simvastatin 40 mg daily

3. Listed below are the baseline and post-treatment LDL-C values for a patient with clinical ASCVD who started on atorvastatin 80 mg daily. The patient is adherent with atorvastatin therapy. According to the 2018 Cholesterol Guideline, for which of these responses should you recommend the addition of a nonstatin medication for further LDL-C lowering?

A. Baseline 150 mg/dL, post-treatment 60 mg/dL B. Baseline 110 mg/dL, post-treatment 50 mg/dL C. Baseline 140 mg/dL, post-treatment 60 mg/dL D. Baseline 180 mg/dL, post-treatment 80 mg/dL

4. Which of the following is a 2018 Cholesterol Guideline risk enhancer?

A. Rheumatoid arthritis B. Osteoporosis C. Irritable bowel disease D. Estimated GFR 75 mL/min/1.75m²

5. A 45-year-old woman with a history of type 2 diabetes presents for follow-up. She has never been on lipid-lowering drug therapy and her current LDL-C is 90 mg/dL. Her 10-year ASCVD risk score is 3.2%. Which regimen is recommended by the 2018 Cholesterol Guideline for treating her?

A. Atorvastatin 40 mg daily B. Pravastatin 40 mg daily C. Rosuvstatin 40 mg daily with ezetimibe 10 mg daily D. No lipid-lowering therapy because her LDL-C is low enough

6. Which of the following lipid-lowering drugs has been shown in clinical trials to reduce risk of ASCVD events when added to statin therapy?

A. Alirocumab B. Colesevelam C. Fenofibric acid D. Niacin

7. A patient is started on statin therapy. After 4 weeks she complains of muscle pain and soreness. A serum CK value is measured and it is 150 IU/L (normal range is 0–200 IU/L) and this patient's pre-statin serum CK value was 100 IU/L. This patient's statin-associated muscle symptoms are best categorized as which of the following?

A. Myopathy B. Myonecrosis C. Myalgia D. Rhabdomyolysis

8. Which is a risk factor for the development of new-onset diabetes after starting statin therapy?

A. Family history of premature ASCVD B. Human immunodeficiency virus C. Albuminuria D. Metabolic syndrome

9. A 48-year-old man has a 10-year ASCVD risk score of 10%. He is a smoker and has a family history of premature ASCVD. Fasting lipid panel is: total cholesterol 190 mg/dL, HDL-C 30 mg/dL, LDL-C 120 mg/dL, and triglycerides 200 mg/dL. These are nearly identical to values measured last year. The patient is reluctant to start statin therapy because he is not convinced he really needs it. Which additional test should be measured in him to provide additional information regarding the need for statin therapy?

A. Serum Lp(a) B. Coronary artery calcium C. Electrocardiogram D. Renal ultrasound

10. A 72-year-old patient with clinical ASCVD is treated with rosuvastatin 40 mg daily. His LDL-C level was 160 mg/dL at baseline and has been reduced to 75 mg/dL by rosuvastatin therapy. Although he is adherent with this medication, he experiences another ASCVD event (an acute coronary syndrome). According to the 2018 Cholesterol Guideline, which medication is recommended as an add-on therapy for this patient?

A. A PCSK9 inhibitor B. EPA containing omega-3 fatty acids C. Ezetimibe D. No additional therapy is recommended