BCACP Hypertension and Dyslipidemia Therapy 4

Question 1

Which fibrate carries the lowest risk of myopathy when used in combination with a statin?

Accepted Answer

Fenofibrate

Answer

Gemfibrozil

Answer

Clofibrate

Answer

All fibrates carry equal risk

Question 2

A patient on lisinopril develops a dry cough. The pharmacist recommends switching to which medication?

Accepted Answer

Losartan

Answer

Captopril

Answer

Enalapril

Answer

Ramipril

Question 3

What is the primary mechanism by which spironolactone lowers blood pressure in resistant hypertension?

Accepted Answer

Aldosterone receptor antagonism promoting sodium excretion

Answer

Beta-1 receptor blockade reducing cardiac output

Answer

Direct arterial vasodilation

Answer

Inhibition of angiotensin-converting enzyme

Question 4

Colesevelam (a bile acid sequestrant) is unique among lipid-lowering agents because it also reduces which other cardiovascular risk marker?

Accepted Answer

Hemoglobin A1c in type 2 diabetes

Answer

Triglycerides

Answer

C-reactive protein

Answer

Lipoprotein(a)

Question 5

A patient with hypertension and a history of angioedema on enalapril is started on sacubitril/valsartan for HFrEF. What important counseling point applies?

Accepted Answer

Sacubitril/valsartan is contraindicated in patients with prior ACE inhibitor angioedema

Answer

Sacubitril/valsartan is safe because it is not an ACE inhibitor

Answer

There must be a 36-hour washout period after stopping the ACE inhibitor before starting sacubitril/valsartan

Answer

The patient should take a 24-hour break before transitioning

Question 6

Which of the following best describes the mechanism of action of bempedoic acid?

Accepted Answer

Inhibits ATP-citrate lyase upstream of HMG-CoA reductase

Answer

Inhibits HMG-CoA reductase in hepatocytes

Answer

Blocks intestinal cholesterol absorption at NPC1L1

Answer

Activates LDL receptor expression via PCSK9 degradation

Question 7

An African American patient with hypertension has a BP of 148/92 mmHg. Which initial therapy is preferred based on clinical trial data and guidelines?

Accepted Answer

Thiazide diuretic or calcium channel blocker

Answer

ACE inhibitor monotherapy

Answer

ARB monotherapy

Answer

Beta-blocker monotherapy