CLS Therapeutic Lifestyle & Pharmacologic Interventions 3

Question 1

Colesevelam (Welchol) has which unique advantage over older bile acid sequestrants like cholestyramine?

Accepted Answer

Improved glycemic control in type 2 diabetes

Answer

Colesevelam is FDA-approved as an adjunct to improve glycemic control in type 2 diabetes in addition to its LDL-C–lowering effect.

Question 2

The REDUCE-IT trial demonstrated that icosapentaenoic acid (EPA, 4g/day) reduced cardiovascular events by approximately what percentage in statin-treated patients with elevated triglycerides?

Accepted Answer

25%

Answer

REDUCE-IT showed icosapentaenoic acid (Vascepa) reduced major adverse cardiovascular events by approximately 25% relative to placebo in high-risk statin-treated patients.

Question 3

Which lipoprotein measurement is most directly reduced by niacin therapy, making it useful in patients with isolated low HDL-C?

Accepted Answer

HDL-C

Answer

Niacin produces the largest increase in HDL-C of any available lipid-modifying drug, typically raising it by 15-35%.

Question 4

A patient on gemfibrozil asks about starting rosuvastatin for elevated LDL-C. What is the primary concern with this combination?

Accepted Answer

Significantly increased risk of myopathy and rhabdomyolysis

Answer

Gemfibrozil inhibits statin glucuronidation, dramatically increasing statin plasma levels and the risk of myopathy; fenofibrate is the preferred fibrate when combined with statins.

Question 5

Plant stanols and sterols reduce LDL-C through which primary mechanism?

Accepted Answer

Competing with dietary cholesterol for intestinal absorption

Answer

Plant stanols and sterols structurally compete with cholesterol for micellar incorporation, reducing intestinal cholesterol absorption by ~30-40%.

(CLS) Clinical Lipid Specialist Certification Practice Test

(CLS) Clinical Lipid Specialist Certification Practice Test

CLS Therapeutic Lifestyle & Pharmacologic Interventions 3