dydlipidmia and HTNcrisis


american board quiz
eman mousTAFA
Quiz by eman mousTAFA, updated more than 1 year ago
eman mousTAFA
Created by eman mousTAFA over 7 years ago

Resource summary

Question 1

A 62-year-old man presents to your medication management clinic for a follow-up pharmacotherapy visit. He had fasting laboratory tests drawn before your visit that reveal the following: low-density lipoprotein (LDL)-direct measurement 147 mg/dL, triglycerides 490, and highdensity lipoprotein (HDL) 34 mg/dL; his hemoglobin A1C is 6.9%. He has concomitant diabetes mellitus (DM) but no diagnosis associated with coronary artery disease (CAD). What is the best initial therapy to treat his lipid lab abnormalities?
  • A. Rosuvastatin 10 mg orally daily
  • B. Pravastatin 10 mg orally daily
  • C. Gemfibrozil 600 mg orally twice daily with meals
  • • D. Fenofibrate 145 mg orally daily

Question 2

A 24-year-old man has new laboratory findings of hypertriglyceridemia. Lipid panel reveals triglycerides (TG) 1700 mg/dL, and high-density lipoprotein (HDL) 35 mg/dL. Patient states that his mom has had pancreatitis “frequently” in the past. Initial therapy should include:
  • • A. Gemfibrozil
  • • B. Fenofibrate
  • • C. Niacin
  • • D. Pravastatin

Question 3

50-year-old woman with no signifcant medical history presents for her annual well woman examination. Fasting laboratory results show TC 157, TG 277, HDL-C 39, LDL-C 63, non–HDL-C 118, SCr 0.9, ALT 20, Na 144, K 4.5, and FBG 99. Her BMI is 30.3. Which is the best recommendation to manage her elevated TG?
  • A. Diet, exercise, and weight loss.
  • B. Fenofbrate 160 mg/day.
  • C. Gemfbrozil 600 mg twice daily.
  • D. Pravastatin 80 mg every evening

Question 4

A 72 years old woman represents to clinic with intolerance to lipid lowering therapy (four different statins and two formulations of niacin). Her medical history is signifcant for DM and osteoporosis. She currently takes alendronate 10 mg/day. She has seen a dietitian to improve her diet and has exercised at least 200 minutes/ week since she was given a diagnosis of DM 10 years ago. Fasting laboratory results show TC 199, TG 115, HDL-C 49, LDL-C 127, non–HDL-C 150, SCr 1.6, ALT 15, and A1C 6.5%. Her BMI is 22.7. Which is the best recommendation to manage her dyslipidemia?
  • A. Weight loss.
  • B. Fenofbrate 160 mg/day.
  • C. Ezetimibe 10 mg/day.
  • D. Simvastatin 80 mg every evening.

Question 5

62 years old woman with a history of three vessel cronary artery bypass grafting 2 years earlier and diabetes completes her fasting laboratory work. Medications include simvastatin 80 mg/day, glipizide 5 mg two times/day, metoprolol SR 25 mg/day, and ASA 81 mg/day. During the past year, she has seen a steady decline in her renal function. Laboratory results show TC 143, TG 160, HDL-C 42, LDL 63, non–HDL-C 101, SCr 2.3, CrCl (IBW) 21.9 mL/minute, ALT 45, Na 144, K 4.9, and A1C 7.5%. She weighs 81 kg and is 5′4′′ tall. Which is the best recommendation for this patien?
  • A. Add omega-3 fatty acids, with at least 1 g/day of EPA/DHA.
  • B. Add fenofbrate 160 mg/day.
  • C. Continue therapy because her LDL-C is at goal.
  • D. Change simvastatin to atorvastatin 40 mg/day because of her kidney function.

Question 6

B.D. is a 76-year-old man whose weight is 194 lb and height is 5′10″ with a history of atrial fibrillation, chronic heart failure, and DM. He presents to the hospital with an MI. His current medications include amiodarone 200 mg/day, insulin, lisinopril 20 mg/day, furosemide 40 mg/day, and metoprolol 50 mg twice daily. Pertinent laboratory values include an SCr of 4.5 mg/dL, AST of 35 units/L, and an LDL-C of 176 mg/dL. Which of the following is the most appropriate medication regimen for this patient?
  • A. Atorvastatin 40 mg orally once daily.
  • B. Atorvastatin 40 mg orally once daily, initiate after AST normalizes.
  • C. Simvastatin 40 mg orally once daily.
  • D. Simvastatin 40 mg orally once daily, initiate after AST normalizes.

Question 7

J.S. is a 62-year-old man (height 5′8′′, weight 120 kg) with a history significant for diabetes, chronic renal insufficiency, CAD, and hypertriglyceridemia, which has resulted in pancreatitis in the past. His family history is also significant for his father having CAD and hypertriglyceridemia. Pertinent laboratory findings include a hemoglobin A1c (A1c) of 7.6% and a serum creatinine (SCr) of 4.0 mg/dL. He currently takes atorvastatin 40 mg every evening, extended-release niacin 2000 mg/day at bedtime, ASA 81 mg/day, and over-the-counter (OTC) fish oil 2 g/day. His fasting lipid profile is total cholesterol (TC), 402 mg/dL; low-density lipoprotein cholesterol (LDL-C), unable to calculate; high-density lipoprotein cholesterol (HDL-C), 48 mg/dL; and triglycerides (TG), 1500 mg/dL. Which one of the following medications and doses would be most appropriate to initiate at this time?
  • A. Increase atorvastatin to 80 mg and add gemfibrozil 600 mg once daily.
  • B. Increase atorvastatin to 80 mg and add fenofibrate (TriCor) 48 mg once daily.
  • C. Add gemfibrozil 600 mg once daily.
  • D. Add fenofibrate (TriCor) 48 mg once daily.

Question 8

M.M. is a 63-year-old woman who just finished 6 months of diet and exercise for dyslipidemia. She has a history of gout, chronic heart failure, HTN, and asthma, as well as a 15 pack/year history of tobacco (but she quit 3 years ago); she drinks three beers a day. Because she was adopted, no family history records are available. Her medications are albuterol (Xopenex HFA) MDI (metered dose inhaler), lisinopril, furosemide, and Tums 2 tablets/day. Vital signs are BP 124/80 mm Hg; HDL 54 mg/dL; LDL 193 mg/dL; TG 148 mg/dL; and TC 236 mg/dL. According to National Cholesterol Education Panel (NCEP) guidelines, which one of the following best describes the number of CHD risk factors that are present?
  • A. Zero.
  • B. One.
  • C. Two.
  • D. Three.

Question 9

Which of the following drugs would be first-line therapy for a patient without documented heart disease who has the following lipid profile: LDL: 138 mg/dL HDL: 20mg/dL Triglycerides: 964 mg/dL
  • a. Atorvastatin (Lipitor)
  • b. Simvastatin (Zocor)
  • c. Lovastatin (Mevacor)
  • d. Gemfibrozil (Lopid)

Question 10

A 53-year-old woman is admitted to the hospital after the worst headache she has ever experienced. Her medical history includes exertional asthma, poorly controlled hypertension (HTN), and hyperlipidemia. She is nonadherent to her medications, and she has not taken her prescribed BP medications for 4 days. Vital signs include BP 220/100 mm Hg and HR 65 beats/minute. She is found to have a cerebrovascular accident. Which agent is most appropriate for this patient’s hypertensive emergency?
  • A. Fenoldopam 0.1 mcg/kg/minute.
  • B. Nicardipine 5 mg/hour.
  • C. Labetalol 0.5 mg/minute.
  • D. Enalaprilat 0.625 mg intravenously every 6 hours

Question 11

63-A 56-year-old white woman, with a long history of HTN because of non adherence and recently diagnosed HF (EF 35%), presents to the local emergency department with a BP 210/120 mm Hg and HR 105 beats/ minute. She states that she felt a little light-headed, but that now, she is feeling okay. She ran out of her BP medications (including HCTZ, carvedilol, and lisinopril) 3 days ago. Current laboratory values are within normal limits. Which medication is best to manage this patient?
  • A. Sodium nitroprusside 0.25 mcg/kg/minute titrated to a 25% reduction in MAP.
  • B. Labetalol 80 mg intravenously x 1; repeat until BP is less than 120/80 mm Hg
  • C. Resumption of home medications; refer for follow-up within 2 days.
  • D. Resumption of home medications; initiate amlodipine 10 mg daily; refer for follow-up in 1 week

Question 12

M.R., a 56-year-old white woman with a long history of HTN because of non-adherence and recently diagnosed HF (EF 35%), presents to the local emergency department with the sudden onset of severe, sharp, and diffuse chest pain that radiates to her back. A physical examination reveals BP 210/120 mm Hg and HR 105 beats/minute but otherwise within normal limits. Current laboratory values are also within normal limits, except for a toxicology screen positive for cocaine. A chest radiograph reveals a widened mediastinum, and a subsequent chest computed tomography scan reveals aortic arch dissection. Which one of the following medications is best to manage M.R.'s hypertensive emergency?
  • A. Esmolol 25 mcg/minute.
  • B. Esmolol 25 mcg/minute followed by sodium nitroprusside 0.5 mcg/kg/minute.
  • C. Sodium nitroprusside 0.5 mcg/kg/minute.
  • D. Labetalol 2 mg/minute followed by sodium nitroprusside 0.5 mcg/kg/minute
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