Which of the following are new categories for lipid management outlined in the 2013 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines (see Box 15.1; Stone et al., 2013)?

1. Individuals with clinical atherosclerotic coronary vascular disease (ASCVD)
   
2. Individuals with primary elevations of low-density lipoprotein cholesterol (LDL-C) ≥190 mg/dL
   
3. Individuals 40–75 years of age with diabetes with LDL-C 70–189 mg/dL
   
4. Individuals without clinical ASCVD or diabetes who are 40–75 years of age with LDL-C 70–189 mg/dL and an estimated 10-year ASCVD risk of 7.5% or higher
   
5. All of the above

What is the target goal low-density lipoprotein (LDL) recommendation (primary and secondary prevention) per the new ACC/AHA guidelines in patients with ASCVD?

1. An LDL goal of <100 mg/dL if not diabetic
   
2. An LDL goal of <70 mg/dL if diabetic
   
3. No target goal recommendation
   
4. None of the above

Which of the following is associated with microalbumnuria?

1. Atorvastatin
   
2. Metoprolol
   
3. Amlodipine
   
4. Lisinopril

The association of statin-induced microalbuminuria is increased with which of the following?

1. Male gender
   
2. Diabetes mellitus
   
3. Coronary artery disease
   
4. Smoking

According to the new ACC/AHA guidelines, what is the definition of high-intensity statin treatment?

1. Daily statin dose reduces LDL-C by 30 to <50%
   
2. Daily statin dose reduces LDL-C by ≥50%
   
3. Daily statin dose reduces LDL-C by 80%
   
4. Daily statin dose reduces LDL-C by 70%

According to the new ACC/AHA guidelines, what is the definition of moderate-intensity statin treatment?

1. Daily statin dose reduces LDL-C by 30 to <50%
   
2. Daily statin dose reduces LDL-C by ≥50%
   
3. Daily statin dose reduces LDL-C by 80%
   
4. Daily statin dose reduces LDL-C by 70%

A 67-year-old male with known history of coronary artery disease (CAD) has an LDL-C of 180 mg/dL. Regarding statin treatment, what is the best course of action?

1. No statin treatment
   
2. High-intensity statin therapy
   
3. Moderate-intensity statin therapy
   
4. Low-intensity statin therapy

A 60-year-old male is referred to you for an evaluation. He has no known history of ASCVD, and his LDL-C is 160 mg/dL. What is the recommendation regarding statin therapy?

1. No statin therapy
   
2. Lifestyle modification
   
3. Lifestyle modification and moderate-intensity statin therapy
   
4. High-intensity statin therapy

A 45-year-old female has no known ASCVD. Her lab work-up reveals an LDL-C of 220 mg/dL. She has no other cardiac risk factors. What is the current recommendation for statin therapy?

1. Lifestyle modification
   
2. Lifestyle modification and reassess in 6 months
   
3. High-intensity statin therapy
   
4. Lifestyle modification and high-intensity statin therapy

A 60-year-old male is referred to you for an evaluation. He has no cardiovascular disease. On his lab work-up the triglycerides are 550 mg/dL. Which of the following is not a cause of elevated triglycerides?

1. Oral estrogens
   
2. Excessive alcohol intake
   
3. Amiodarone
   
4. Diabetes mellitus

Elevated LDL-C is associated with which of the following?

1. Diuretics
   
2. Cyclosporine
   
3. Amiodarone
   
4. Biliary obstruction
   
5. All of the above
   
6. None of the above

Regarding primary prevention, in a person with no diabetes, LDL-C between 70 and 189 mg/dL, and not receiving statin therapy, what is the current recommendation?

1. Initiate statin therapy
   
2. Estimate 10-year ASCVD risk every 4–6 years
   
3. Estimate 10-year ASCVD risk every year
   
4. None of the above

What is the current recommendation regarding primary prevention when the 10-year ASCVD risk is ≥7.5%?

1. No statin therapy
   
2. Moderate- or high-intensity statin therapy
   
3. Moderate-intensity statin therapy only
   
4. High-intensity statin therapy only
   
5. None of the above

What is the current recommendation regarding primary prevention when the 10-year ASCVD risk is 5 to 7.5%?

1. No statin therapy
   
2. Moderate- or high-intensity statin therapy
   
3. Moderate-intensity statin therapy
   
4. High-intensity statin therapy
   
5. None of the above

Dyslipidemia, consisting of an increase in LDL and triglycerides and a decrease in high-density lipoprotein (HDL), is not associated with which of the following?

1. Protease inhibitors
   
2. Non-nucleoside reverse transcriptase inhibitors
   
3. Nucleoside reverse transcriptase inhibitors
   
4. Fusion/entry inhibitors

A 45-year-old woman asks if she should take statins as her father had a myocardial infarction at the age of 60 and she smokes 10 cigarettes a day. She has no diabetes or hypertension and no cardiac history or symptoms and jogs 20 miles a week. Her body mass index (BMI) is 25 kg/m². What will be the LDL threshold for starting a statin based on the ACC/AHA guidelines for this patient?

1. >190 mg/dL
   
2. >160 mg/dL
   
3. >130 mg/dL
   
4. >100 mg/dL

A 45-year-old man post-renal transplant is referred for advice on lipid management. He is diabetic and hypertensive and is on aspirin, beta blocker, angiotensin-converting-enzyme inhibitor, and cyclosporine. HDL-C is 30 mg/dL and LDL-C is 145 mg/dL; BMI is 25 kg/m². In addition to lifestyle changes, what else would you recommend?

1. Nothing else
   
2. Simvastatin 20 mg/day
   
3. Niacin
   
4. Pravastatin 40 mg/day

A 55-year-old man had an ST-elevation myocardial infarction and underwent a successful percutaneous coronary intervention. He has now returned for a follow-up visit after 6 weeks. He is doing well and is on atenolol 50 mg/day, aspirin 81 mg, clopidogrel 75 mg, atorvastatin 80 mg/day, and lisonopril 10 mg/day. His repeat HDL is 40 mg/dL; LDL is 78 mg/dL and triglycerides is 142 mg/dL. What would you recommend?

1. Switch to Crestor® 40 mg/day to achieve LDL of <70 mg/dL
   
2. Add ezetimibe
   
3. Add niacin
   
4. Stay on current therapy

A 42-year-old woman presents with hypertension and diabetes. Her weight is 320 lbs (145 kg) and BMI is 43 kg/m². In addition to treating hypertension and diabetes, what are your other recommendations?

1. Moderate-dose statin therapy
   
2. Exercise, healthy diet, and target a net calorie deficit of 500–750 kcal/day
   
3. Lose 30 lbs (∼14 kg) of weight over next 6 months
   
4. All of the above
   
5. None of the above

According 2013 obesity guidelines (Box 15.3), weight loss in recommended in which of the following?

1. Individuals with a BMI >30 kg/m² even without risk factors
   
2. Individuals with BMI 25–30 kg/m² with risk factors
   
3. Both A and B
   
4. Neither A nor B

Adding US Food and Drug Administration-approved pharmacotherapy as an adjunct to comprehensive lifestyle intervention is reasonable in which of the following conditions?

1. Those with a BMI ≥30 kg/m² who are motivated to lose weight
   
2. Those with a BMI ≥27 kg/m² with at least one obesity-associated comorbid condition who are motivated to lose weight
   
3. Both A and B
   
4. Neither A nor B

In the management of obesity, when is it appropriate to refer to an experienced bariatric surgeon for consultation and evaluation of patients who are motivated to lose weight and who have not responded to behavioral treatment (with or without pharmacotherapy)?

1. When BMI ≥40 kg/m²
   
2. When BMI ≥35 kg/m² with obesity-related comorbidities or complications
   
3. Both A and B
   
4. Neither A nor B

A 42-year-old man comes to see you to assess cardiovascular risk and recommendations. He is obese, but has no other medical history and has started on an exercise and diet program. His height is 70^″, weight 220 lbs (∼100 kg), BMI 32 kg/m², heart rate 70 bpm, blood pressure 130/80 mmHg. His LDL is 135 mg/dL and HDL is 35 mg/dL, glucose is 88 mg/dL, hemoglobin A1C is 6.2%. His 10-year risk of a cardiovascular event is 3%. What will you recommend?

1. A stress test
   
2. Coronary computed tomography (CT) angiogram
   
3. Carotid intimal medial thickness with ultrasound
   
4. No further testing, continue current strategy

An 80-year-old man had a myocardial infarction 7 years ago and is on atenolol 50 mg/day, aspirin 81 mg/day, and atorvastatin 20 mg/day. What is your recommendation for the statin as he is >75 years old?

1. Stop statin as he is above 75 years
   
2. Increase statin to 40 or 80 mg/day (high intensity)
   
3. Ask for patient preference in view of paucity of data in patients >75 years of age
   
4. Switch to ezetimibe

A 70-year-old Japanese woman received an left anterior descending coronary artery stent for ST-elevation myocardial infarction. She is doing well and is on atorvastatin 80 mg/day, atenolol 25 mg/day, aspirin 81 mg/day, and clopidogrel 75 mg/day. Her LDL is 85 mg/dL. What would you recommend?

1. Reduce statin
   
2. Switch to rosuvastatin 40 mg/day
   
3. Add niacin
   
4. Add ezetimibe

Which of the following is a class I recommendation in assessing asymptomatic adults with no known CAD?

1. Genomic testing
   
2. Obtain global risk score (Framingham)
   
3. Assessment of lipoprotein and apolipoprotein
   
4. Measurements of natriuretic peptides