17. Atherosclerosis
1. Which of the following is false?
a. For every 1% decrease in LDL-C, the risk of coronary heart disease is reduced by 1%.
b. Both low HDL-C and high triglyceride levels have been shown to independently predict coronary heart disease risk.
c. Each 1% increase in LDL-C has been associated with a 7% to 8% increase in coronary heart disease events.
d. HDL-C has been correlated with coronary heart disease events regardless of total cholesterol or LDL-C levels.
2. According to the ATP III guidelines, which of the following risk factors would be classified as metabolic syndrome?
a. abdominal obesity: men with a waist circumference of 102 cm or greater and women with a waist circumference of 88 cm or greater; LDL-C levels of 130 mg/dl or less; triglyceride levels of 200 mg/dl (2.26 mmol/l) or greater
b. blood pressure: 130/85 mm Hg or higher; fasting glucose levels of 100 mg/dl (5.5 mmol/l) or greater; triglyceride levels above 150 mg/dl (1.7 mmol/l)
c. HDL-C: men below 40 mg/dl (1 mmol/l) and women below 50 mg/dl (1.3 mmol/l); blood pressure 140/90 or higher; postprandial glucose levels of 126 mg/dl (6.9 mmol/l) or greater
d. none of the above
3. Atherogenic dyslipidemia is a triad of lipid abnormalities defined as:
a. small, dense LDL particles; high LDL-C levels; and low HDL-C levels
b. high triglyceride levels; small, dense LDL particles; and high LDL-C levels
c. low HDL-C levels; high triglyceride levels; and small, dense LDL particles
d. high triglyceride levels; high LDL-C levels; and low HDL-C levels
4. Which of the following statements regarding the treatment of dyslipidemia is false?
a. Bile acid sequestrants are a good option for patients who are intolerant of statin therapy or whose condition is refractory to statins.
b. Cholesterol absorption inhibitors lower triglyceride/cholesterol (TG-C) levels by 20% regardless of concurrent therapy.
c. Fibrates are recommended for patients with hypertriglyceridemia and atherogenic dyslipidemia.
d. Niacin is recommended for patients with isolated, low HDL-C levels and atherogenic dyslipidemia.
5. Which of the following statements is false?
a. Statins are the most potent drugs available for lowering LDL-C levels.
b. Fibrates exert their greatest effect on triglyceride levels.
c. Niacin is the most effective drug for HDL-C.
d. Bile acid sequestrants primarily affect triglyceride levels.
6. What are some indications and advantages of combination therapy?
a. It can act at different stages of lipid metabolism.
b. It is an important option for patients who have persistent abnormalities of more than one component of the lipid profile.
c. It provides an option for patients who have not achieved lipid goals after monotherapy.
d. all of the above
7. What is not an advantage of using statins plus niacin?
a. This combination can reduce LDL-C levels by 29% to 44%.
b. This combination can reduce triglyceride levels by 15% to 39%.
c. This combination can reduce HDL-C levels by 14% to 36%.
d. Myopathy has rarely been reported in statin–niacin combination therapy.
8. The combination of statins and fibrates tends to:
a. decrease LDL levels and increase triglyceride levels.
b. decrease HDL levels and decrease triglyceride levels.
c. increase LDL levels and increase HDL levels.
d. decrease LDL levels and decrease triglyceride levels.
9. The ATP III recommendations that address patient adherence include which one of the following?
a. Keep the regimen as simple as possible.
b. Concentrate on patients who do not reach treatment goals.
c. Use two or more strategies for patients who do not meet treatment goals.
d. all of the above
10. Regarding combination therapy, all of the following statements are true except:
a. Atorvastatin plus fenofibrate has been shown to significantly reduce the 10-year probability of myocardial infarction.
b. Atorvastatin or lovastatin plus a bile acid sequestrant, such as colesevelam, can reduce LDL-C levels, increase HDL-C levels, and reduce triglycerides levels.
c. The combination of ezetimibe and statins is simply too potent for patients; thus, this combination is not recommended.
d. Niacin plus bile acid sequestrants is a good option for patients with multiple lipid abnormalities or for those who cannot tolerate statins or achieve adequate LDL-C reduction with monotherapy.