CLS Familial Hypercholesterolemia Management 3

Question 1

Ezetimibe lowers LDL-C in FH patients primarily through which mechanism?

Accepted Answer

Blocking NPC1L1 transporter in intestinal enterocytes

Answer

Ezetimibe inhibits the NPC1L1 transporter at the brush border of intestinal enterocytes, reducing cholesterol absorption by approximately 50%.

Question 2

Which PCSK9 inhibitor was the first FDA-approved monoclonal antibody for reducing LDL-C in heterozygous FH?

Accepted Answer

Alirocumab

Answer

Alirocumab (Praluent) was the first PCSK9 inhibitor approved by the FDA in 2015 for heterozygous FH management.

Question 3

Inclisiran differs from monoclonal antibody PCSK9 inhibitors in that it:

Accepted Answer

Uses siRNA to suppress hepatic PCSK9 synthesis, allowing twice-yearly dosing

Answer

Inclisiran is an siRNA that silences PCSK9 mRNA in hepatocytes, reducing PCSK9 production and enabling dosing only twice per year after initiation.

Question 4

Lomitapide is approved for homozygous FH and works by inhibiting which protein?

Accepted Answer

Microsomal triglyceride transfer protein (MTP)

Answer

Lomitapide inhibits MTP, which is essential for assembling VLDL and chylomicrons, thereby reducing hepatic and intestinal lipoprotein secretion.

Question 5

Bempedoic acid reduces LDL-C in FH patients by inhibiting ATP citrate lyase. Its key advantage over statins is that it:

Accepted Answer

Is activated only in the liver, minimizing muscle-related side effects

Answer

Bempedoic acid requires hepatic activation by ACSVL1 and is not converted to its active form in muscle, reducing the risk of myopathy seen with statins.

(CLS) Clinical Lipid Specialist Certification Practice Test

(CLS) Clinical Lipid Specialist Certification Practice Test

CLS Familial Hypercholesterolemia Management 3