CLS Lipid Panel Interpretation 5

Question 1

A patient on a high-intensity statin has a follow-up LDL-C of 58 mg/dL (down from 142 mg/dL at baseline). How should this response be interpreted?

Accepted Answer

Adequate response; high-intensity statin should achieve ≥50% LDL-C reduction

Answer

Inadequate response; high-intensity statin should be replaced with ezetimibe

Answer

Inadequate response; a ≥75% reduction is required for all statin-treated patients

Answer

Excellent response but LDL-C below 50 mg/dL raises safety concerns requiring dose reduction

Question 2

Which secondary cause of dyslipidemia classically produces elevated triglycerides and decreased HDL-C (type IV pattern)?

Accepted Answer

Poorly controlled type 2 diabetes mellitus

Answer

Hypothyroidism

Answer

Nephrotic syndrome

Answer

Primary biliary cholangitis

Question 3

What does a coronary artery calcium (CAC) score of zero add to lipid panel interpretation for an intermediate-risk patient?

Accepted Answer

Identifies a low-risk group that may safely defer statin therapy and intensify lifestyle modification

Answer

Confirms that statin therapy should be initiated immediately regardless of lipid values

Answer

Indicates the patient has familial hypercholesterolemia and needs genetic testing

Answer

Suggests HDL-C measurement was erroneous and requires direct assay

Question 4

A 45-year-old man has LDL-C 195 mg/dL, normal TG, normal HDL-C, no secondary causes, and a family history of premature ASCVD. According to the Dutch Lipid Clinic Network criteria, what diagnosis is most likely?

Accepted Answer

Heterozygous familial hypercholesterolemia

Answer

Type IIb hyperlipoproteinemia

Answer

Familial combined hyperlipidemia

Answer

Polygenic hypercholesterolemia

Question 5

After initiating fenofibrate therapy, which lipid panel change would you most expect at 3 months?

Accepted Answer

20–50% reduction in TG and 10–20% increase in HDL-C

Answer

40–50% reduction in LDL-C with minimal TG effect

Answer

15–20% reduction in total cholesterol with unchanged TG

Answer

Marked Lp(a) reduction with mild TG reduction

Question 6

A postmenopausal woman starts oral estrogen-based hormone therapy. Which lipid panel change is most expected?

Accepted Answer

LDL-C decreases and TG increases

Answer

LDL-C increases and HDL-C decreases

Answer

Both LDL-C and TG decrease with no change in HDL-C

Answer

HDL-C decreases and LDL-C remains unchanged

Question 7

In interpreting a lipid panel for cardiovascular risk, which metric has been shown to be the best predictor of ASCVD events when LDL-C and apoB are discordant?

Accepted Answer

Apolipoprotein B

Answer

Total cholesterol

Answer

Non-HDL cholesterol

Answer

HDL-C