CLS Pediatric Lipid Disorders 2 — Questions and Answers
Question 1: At what age does the American Academy of Pediatrics recommend universal lipid screening for children?
- Age 3-5 years
- Age 9-11 years (Correct answer)
- Age 6-8 years
- Age 12-14 years
Correct answer: Age 9-11 years
Universal lipid screening is recommended for all children at ages 9-11 years and again at ages 17-21 years.
Question 2: Which lipoprotein particle is most atherogenic in children with familial hypercholesterolemia?
- HDL-C
- VLDL
- LDL-C (Correct answer)
- Chylomicrons
Correct answer: LDL-C
LDL-C is the primary atherogenic particle in heterozygous and homozygous familial hypercholesterolemia in children.
Question 3: A 10-year-old presents with tendon xanthomas and an LDL-C of 520 mg/dL. Which diagnosis is most consistent?
- Familial combined hyperlipidemia
- Homozygous familial hypercholesterolemia (Correct answer)
- Heterozygous familial hypercholesterolemia
- Polygenic hypercholesterolemia
Correct answer: Homozygous familial hypercholesterolemia
Tendon xanthomas with LDL-C >400 mg/dL in a child strongly suggests homozygous familial hypercholesterolemia.
Question 4: Which statin is FDA-approved for use in children as young as 8 years of age with heterozygous FH?
- Rosuvastatin
- Atorvastatin
- Pravastatin (Correct answer)
- Simvastatin
Correct answer: Pravastatin
Pravastatin is approved for children aged 8 and older with heterozygous familial hypercholesterolemia.
Question 5: In pediatric hypertriglyceridemia, which triglyceride level threshold raises concern for pancreatitis risk?
- >150 mg/dL
- >200 mg/dL
- >500 mg/dL (Correct answer)
- >1000 mg/dL
Correct answer: >500 mg/dL
Triglyceride levels exceeding 500 mg/dL significantly increase pancreatitis risk and require prompt intervention.
Question 6: Which genetic mutation is most commonly associated with familial hypercholesterolemia in children?
- PCSK9 gain-of-function
- LDLR loss-of-function (Correct answer)
- APOB mutation
- LDLRAP1 mutation
Correct answer: LDLR loss-of-function
Loss-of-function mutations in the LDLR gene account for approximately 80% of familial hypercholesterolemia cases.
Question 7: What is the recommended LDL-C target for a high-risk child with heterozygous FH and additional cardiovascular risk factors?
- <130 mg/dL
- <110 mg/dL
- <100 mg/dL (Correct answer)
- <70 mg/dL
Correct answer: <100 mg/dL
For high-risk pediatric patients with FH and additional risk factors, an LDL-C goal of <100 mg/dL is recommended.
CLS Pediatric Lipid Disorders 2
At what age does the American Academy of Pediatrics recommend universal lipid screening for children?