CLS CLS Special Populations in Lipid Management 1

Question 1

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

Accepted Answer

Statins

Answer

Statins are absolutely contraindicated in pregnancy (Category X) because cholesterol is essential for fetal development and statins are teratogenic.

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

KDIGO guidelines recommend statin or statin/ezetimibe combination therapy for CKD stages 3–5 not on dialysis to reduce cardiovascular risk.

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

The 4D and AURORA trials showed no cardiovascular benefit from initiating statins in dialysis patients, so current guidelines recommend not starting them de novo in this population.

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

Pravastatin and rosuvastatin are preferred in HIV patients on protease inhibitors because they have minimal CYP3A4 metabolism, avoiding dangerous drug interactions.

Question 5

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

Accepted Answer

Increased estrogen stimulates hepatic VLDL production

Answer

Estrogen during pregnancy stimulates hepatic VLDL production, causing a physiologic rise in triglycerides that can unmask underlying hypertriglyceridemia disorders.

(CLS) Clinical Lipid Specialist Certification Practice Test

(CLS) Clinical Lipid Specialist Certification Practice Test

CLS CLS Special Populations in Lipid Management 1