CLS CLS Special Populations in Lipid Management

Question 1

Which lipid-lowering medication is absolutely contraindicated in pregnancy due to teratogenicity?

Accepted Answer

Statins

Answer

Bile acid sequestrants

Answer

Ezetimibe at high doses

Answer

Omega-3 fatty acids

Question 2

In patients with chronic kidney disease (CKD) stages 3–5 not on dialysis, which lipid-lowering therapy is recommended by KDIGO guidelines?

Accepted Answer

Statin or statin/ezetimibe combination

Answer

PCSK9 inhibitors as first-line

Answer

Fibrates as first-line

Answer

Niacin monotherapy

Question 3

What is the recommended approach to lipid-lowering therapy in patients on hemodialysis, based on evidence from the 4D and AURORA trials?

Accepted Answer

Statins should not be initiated de novo in dialysis patients but may be continued if already prescribed

Answer

Statins are first-line therapy for all dialysis patients

Answer

PCSK9 inhibitors replace statins in dialysis

Answer

Fibrates are the preferred therapy

Question 4

In patients with HIV on antiretroviral therapy, which statin is preferred due to minimal interaction with protease inhibitors?

Accepted Answer

Pravastatin or rosuvastatin

Answer

Simvastatin or lovastatin

Answer

Atorvastatin at high dose

Answer

Fluvastatin only

Question 5

Which physiologic change during pregnancy normally causes triglyceride levels to increase?

Accepted Answer

Increased estrogen stimulates hepatic VLDL production

Answer

Reduced renal triglyceride clearance

Answer

Gestational diabetes in all pregnancies

Answer

Decreased lipoprotein lipase activity from fetal demand

Question 6

In elderly patients (>75 years) without established cardiovascular disease, the decision to initiate statin therapy should prioritize which consideration?

Accepted Answer

Shared decision-making weighing benefit, polypharmacy, functional status, and life expectancy

Answer

Aggressive LDL lowering to <55 mg/dL regardless of comorbidities

Answer

Avoiding all statins due to myopathy risk

Answer

Using only fibrates in this age group