BCACP Hypertension and Dyslipidemia Therapy 2

Question 1

A patient with stage 2 hypertension and CKD (eGFR 35 mL/min) is started on lisinopril 10 mg daily. Two weeks later, serum creatinine rises 25% from baseline. What is the most appropriate next step?

Accepted Answer

Continue lisinopril; a <30% creatinine rise is acceptable

Answer

An increase in serum creatinine up to 30% above baseline after initiating an ACE inhibitor is acceptable and expected due to reduced glomerular efferent vasoconstriction.

Question 2

Which antihypertensive drug class is most associated with causing hyperkalemia in patients with CKD?

Accepted Answer

ACE inhibitors

Answer

ACE inhibitors block angiotensin II–mediated aldosterone release, reducing potassium excretion and predisposing CKD patients to hyperkalemia.

Question 3

A patient on rosuvastatin 20 mg develops unexplained muscle pain. CK is 12,000 U/L. What is the most appropriate action?

Accepted Answer

Discontinue rosuvastatin immediately

Answer

Markedly elevated CK (>10× ULN) with muscle symptoms indicates myopathy/rhabdomyolysis and requires immediate statin discontinuation.

Question 4

According to ACC/AHA guidelines, which patient qualifies for high-intensity statin therapy based on ASCVD risk alone?

Accepted Answer

60-year-old with established ASCVD

Answer

Established ASCVD is a primary indication for high-intensity statin therapy regardless of baseline LDL.

Question 5

A pregnant patient in her first trimester is found to have a BP of 158/102 mmHg. Which antihypertensive is CONTRAINDICATED?

Accepted Answer

Lisinopril

Answer

ACE inhibitors are contraindicated in pregnancy due to risk of fetal renal dysgenesis, oligohydramnios, and neonatal renal failure.

BCACP - Board Certified Ambulatory Care Pharmacist Exam Practice Test

BCACP - Board Certified Ambulatory Care Pharmacist Exam Practice Test

BCACP Hypertension and Dyslipidemia Therapy 2