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

High-intensity statin therapy is expected to lower LDL-C by ≥50%; this patient achieved a 59% reduction, which is a satisfactory pharmacologic response.

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

Poorly controlled type 2 diabetes causes insulin resistance that increases VLDL production and reduces lipoprotein lipase activity, leading to elevated TG, low HDL-C, and small dense LDL—a classic type IV pattern.

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

A CAC score of zero in an intermediate-risk patient indicates very low near-term ASCVD event risk and supports deferral of statin therapy with aggressive lifestyle modification and reassessment.

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

The combination of LDL-C ≥190 mg/dL, absence of secondary causes, and family history of premature ASCVD meets diagnostic criteria for heterozygous familial hypercholesterolemia using the Dutch Lipid Clinic Network scoring system.

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

Fibrates primarily activate PPARα, increasing lipoprotein lipase activity and reducing VLDL synthesis, resulting in 20–50% TG reduction and 10–20% HDL-C increase with modest and variable effects on LDL-C.

(CLS) Clinical Lipid Specialist Certification Practice Test

(CLS) Clinical Lipid Specialist Certification Practice Test

CLS Lipid Panel Interpretation 5