Mer Scott
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PHCY310 Quiz on L30 Therapeutics of hyperlipidemia, created by Mer Scott on 16/04/2019.

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L30 Therapeutics of hyperlipidemia

Question 1 of 13

1

Choose the incorrect statement.

Select one of the following:

  • For a person with CVR of 5-15%, the benefits of lipid lowering medicines are likely to outweigh adverse effects.

  • Lipid lowering medicines are strongly recommended for people with over 15% CVR.

  • Lipid lowering medicines are recommended for people with under 5% CVR.

Explanation

Question 2 of 13

1

Lifestyle modifications are recommended for everyone to reduce CV risk​: healthy diet, regular exercise, weight management, and smoking cessation​.

Select one of the following:

  • True
  • False

Explanation

Question 3 of 13

1

The current advice is for adults to do 90 minutes of moderate-intensity exercise at least 5 times a week​.

Select one of the following:

  • True
  • False

Explanation

Question 4 of 13

1

Primary prevention is for patients with no evidence of CHD or major atherosclerotic disease​, whereas secondary prevention is for patients who have already had a cardiac event.

Select one of the following:

  • True
  • False

Explanation

Question 5 of 13

1

Which of these is NOT a lipid lowering medicine?Five main classes of lipid lowering drugs available​

Select one of the following:

  • Cholesterol absorption inhibitors​

  • Nicotinic acid derivatives

  • Bile acid binding agents​

  • Fibrates​

  • Statins

  • Anti-platelets

Explanation

Question 6 of 13

1

Statins are first line. They are HMG-CoA reductase inhibitors, meaning cannot reduce to acid, which is the precursor to cholesterol. They are very effective in lowering and proven to decrease of CHD, stroke and death​.

Drag and drop to complete the text.

    HMG-CoA reductase
    HMG-CoA
    mevalonic
    LDL
    risk

Explanation

Question 7 of 13

1

Doubling the dose of a statin achieves a 20% additional average reduction​.

Select one of the following:

  • True
  • False

Explanation

Question 8 of 13

1

Cholesterol synthesis peaks overnight so half life statins (e.g. ) are recommended to be taken at ​.
Statins with a half-life (e.g. ) can be taken either in the morning or at night and have the same efficacy​,

Drag and drop to complete the text.

    simvastatin
    long
    short
    night
    atorvastatin

Explanation

Question 9 of 13

1

Statins are well tolerated​ but ADRs may include elevated liver enzymes, myopathy and rhabdomyolysis​.
- Increased liver reported in less than 2% of patients – obtain levels at baseline​
- Myopathy is muscle symptoms () with a kinase level x10 than normal​
- Rhabdomyolysis (rare) is muscle and the release of intracellular muscle constituents in the blood stream, presenting with muscle pain, elevated creatine kinase, brown and myoglobinuria​.

Drag and drop to complete the text.

    enzymes
    pain
    creatine
    necrosis
    urine

Explanation

Question 10 of 13

1

Statins can be used in pregnancy and when breastfeeding.

Select one of the following:

  • True
  • False

Explanation

Question 11 of 13

1

Fibrates decrease levels (20%-50%) and increase levels by (9%-30%)​. They work by reducing apoproteins and increasing apoproteins .
Common side effects are dyspepsia, pain, diarrhoea, flatulence, rash, muscle pain and ​. Myopathy and rhabdomyolysis can occur – the risk increases with insufficiency and concurrent use of statins. They be given in pregnant or breastfeeding women.

Drag and drop to complete the text.

    triglyceride
    HDL
    B, C-111 and E
    A-1 and A-11
    abdominal
    fatigue
    renal
    cannot

Explanation

Question 12 of 13

1

Bile acid binding agents​ available in NZ are cholestyramine and colestipol. These are bile acid binding resins/sequestrants ​which to bile acids (produced from ) in the gut​. The resin-bile acid complex is then in the faeces​. The loss of bile causes a ’’ response – conversion of hepatic cholesterol to bile (leading to reduction in hepatocellular stores)​.
This drug is not absorbed so side effects are limited to the tract​. 20% of patients report constipation, bloating and flatulence, causing some to stop therapy​. You can increase intake to minimize constipation​.
Time until peak effect of these drugs is generally 2-4 ​.
Patients taking other medications should be advised of the potential for absorption of other medicines – space out dose​.
Not suitable for pregnant and breastfeeding women.

Drag and drop to complete the text.

    bind
    cholesterol
    excreted
    compensatory
    GI
    fluid
    weeks
    decreased

Explanation

Question 13 of 13

1

Cholesterol absorption inhibitors: Ezetimibe
Interacts with a cholesterol in the intestinal , and stops cholesterol from the GI tract.​
Ezetimibe should be prescribed either with a statin, fibrate or nicotinic acid derivative – by itself​. It has a synergistic effect in lowering LDL levels when used with statin​.
AVOID IN PREGNANCY AND BREASTFEEDING​

Drag and drop to complete the text.

    transporter
    membrane
    reabsorption
    rarely

Explanation