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Cholesterol: Managing Its Effect on Cardiovascular Disease risk


For each of the questions or incomplete statements below, ONE OR MORE answer(s) may be correct.
1. Which one of the following represents the low-density lipoprotein cholesterol (LDL-C) goals in mg/dL for the three categories of risk outlined by the National Cholesterol Education Program's Adult Treatment Panel III (NCEP ATP III) guidelines?
A. < 100, < 150, and < 175.
B. < 130, < 160, and < 190.
C. < 100, < 120, and < 140.
D. < 100, < 130, and < 160.


2. Which of the following is true of a non-high-density lipoprotein cholesterol (HDL-C) measurement?
A. Total cholesterol (TC) minus HDL-C.
B. Simpler, less expensive, and potentially as informative as a fasting lipoprotein profile.
C. Particularly useful in the presence of elevated triglycerides (TG).
D. All of the above.


3. Which one of the following includes the determinants used in the NCEP ATP III's assessment tool to quickly calculate 10-year risk for developing coronary heart disease (CHD)?
A. Cigarette smoking, blood pressure, HDL-C, TC, gender, and age.
B. Waist circumference, HDL-C, TG, and fasting glucose.
C. The presence of metabolic syndrome, hypertriglyceridemia, diabetes, and previous coronary events.
D. None of the above.


4. Which one of the following is not true concerning people with type 2 diabetes mellitus?
A. They have high rates of hypertension and obesity.
B. They are at high risk for a heart attack, but at less risk than those who have had a previous heart attack.
C. They benefit from lipid-lowering therapy as much or more than people without the disease.
D. They are generally ill-informed about the connections between cholesterol and diabetes.


5. Which one of the following is not true concerning metabolic syndrome?
A. Metabolic syndrome affects approximately 25 million Americans.
B. Metabolic syndrome is more prevalent among people with a high body mass index who carry their weight centrally than among thin or peripherally overweight individuals.
C. The incidence of cardiovascular disease, diabetes, and all-cause mortality is increased in people with the syndrome, even in the absence of baseline cardiovascular disease and diabetes.
D. Treatment of the syndrome is an important secondary target of lipid-lowering therapy.


6. Which one of the following is not true concerning the Therapeutic Lifestyle Changes diet?
A. A diet low in saturated fat, transfatty acids, and cholesterol and that contains soy protein, fiber, and plant sterols/stanols can be just as effective as a statin at decreasing serum TC and LDL-C levels.
B. Substitution of low-fiber carbohydrates for saturated fatty acids can decrease HDL-C and increase TG.
C. Total fat consumed is a primary target.
D. For every 1% increase in calories from saturated fatty acids as a percent of total energy, serum LDL-C rises about 2%.


7. Which one of the following is not true concerning lipid-altering drug therapy?
A. Less than one half of people with CHD will achieve an LDL-C of < 100 mg/dL on standard statin doses.
B. Lipid-lowering effect is directly proportional to dose.
C. LDL-C is the primary target of therapy except when TG levels are extremely elevated.
D. Therapy should initially be monitored at 6-week intervals.


8. Which one of the following is not true concerning statins?
A. Statins are usually taken in the evening.
B. As TG levels increase, higher doses of statins are required.
C. Statins provide cardioprotective benefit even when LDL-C levels are not elevated.
D. Statins are a good choice regardless of TG level.


9. Which one of the following statements is not true?
A. Adding a bile acid sequestrant to therapy with a statin can provide twice as much LDL-C level reduction as doubling the dose of the statin.
B. Bile acid sequestrants lack systemic toxicity.
C. Nicotinic acid and niacin are among the least effective agents for modifying lipoprotein abnormalities associated with atherogenic dyslipidemia.
D. Fibrates are used primarily for lowering TG, not LDL-C.


10. Which one of the following statements is not true?
A. Estrogen replacement therapy is currently recommended as first-line therapy for hyperlipidemia in postmenopausal women.
B. While only about 1 in 28 women will die of breast cancer, 1 in 2 will die of cardiovascular disease.
C. Lipid screening during the first 24 hours of hospitalization is likely to yield artificially low LDL-C and HDL-C levels.
D. LDL-C levels decline in predictive power as people age.


11. Which one of the following is the primary target of lipid treatment?
A. HDL cholesterol.
B. Low-density lipoprotein (LDL) cholesterol.
C. TC.
D. TG.


12. Which of the following are components of the recommended diet for controlling dyslipidemia?
A. Low-fat foods.
B. High-fiber foods.
C. Five servings of fruits and vegetables per day.
D. All of the above.
E. None of the above.


13. Which one of the following symptoms represent the metabolic syndrome?
A. Abdominal obesity, low blood pressure, high triglycerides, low HDL cholesterol, and high plasma glucose.
B. Abdominal obesity, high blood pressure, high triglycerides, low HDL cholesterol, and low plasma glucose.
C. Abdominal obesity, high blood pressure, high triglycerides, low HDL cholesterol, and high plasma glucose.
D. Abdominal obesity, high blood pressure, low triglycerides, low HDL cholesterol, and low plasma glucose.
E. Abdominal obesity, high blood pressure, high triglycerides, high HDL cholesterol, and low plasma glucose.


14. Familial hypercholesterolemia responds well to dietary changes.
A. True.
B. False.


15. Which one of the following is true of high-protein, low-carbohydrate diets?
A. They are effective in the long term and safe to use.
B. They are effective in the short term and safe to use.
C. They are not effective in the long term but are safe to use.
D. They are effective in the short term but not safe to use.




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