MCQs PHARMACOLOGY: Antihyperlipidemic Drugs

001. Lipoprotein is: a) A conjugated protein having a lipid component; the principal means for transporting lipids in the blood b) Any of various fat-soluble or water-soluble organic substances essential in minute amounts for normal growth and activity of the body and obtained naturally from plant and animal foods c) Product of endocrine gland secretion d) Mediators of inflammatory process
002. Very low density lipoprotein (VLDL) is: a) A lipoprotein containing a very large proportion of lipids to protein and carrying most cholesterol from the liver to the tissues b) A lipoprotein that contains relatively high amounts of cholesterol and is associated with an increased risk of atherosclerosis and coronary artery disease. It is also called beta-lipoprotein c) A lipoprotein that contains relatively small amounts of cholesterol and triglycerides and is associated with a decreased risk of atherosclerosis and coronary artery disease. It is also called alpha-lipoprotein d) Large lipoprotein particle that is created by the absorptive cells of the small intestine. It transports lipids to adipose tissue where they are broken down by lipoprotein lipase
003. Low-density lipoprotein (LDL) is: a) A lipoprotein that contains relatively high amounts of cholesterol and is associated with an increased risk of atherosclerosis and coronary artery disease. It is also called beta-lipoprotein b) A lipoprotein that contains relatively small amounts of cholesterol and triglycerides and is associated with a decreased risk of atherosclerosis and coronary artery disease. It is also called alpha-lipoprotein c) A lipoprotein containing a very large proportion of lipids to protein and carrying most cholesterol from the liver to the tissues d) Large lipoprotein particle that is created by the absorptive cells of the small intestine. It transports lipids to adipose tissue where they are broken down by lipoprotein lipase 004. High-density lipoprotein (HDL) is: a) A lipoprotein that contains relatively small amounts of cholesterol and triglycerides and is associated with a decreased risk of atherosclerosis and coronary artery disease. It is also called alpha-lipoprotein b) A lipoprotein containing a very large proportion of lipids to protein and carrying most cholesterol from the liver to the tissues c) A lipoprotein that contains relatively high amounts of cholesterol and is associated with an increased risk of atherosclerosis and coronary artery disease. It is also called beta-lipoprotein d) Large lipoprotein particle that is created by the absorptive cells of the small intestine. It transports lipids to adipose tissue where they are broken down by lipoprotein lipase
005. Chylomicron is: a) A lipoprotein that contains relatively small amounts of cholesterol and triglycerides and is associated with a decreased risk of atherosclerosis and coronary artery disease. It is also called alpha-lipoprotein b) A lipoprotein containing a very large proportion of lipids to protein and carrying most cholesterol from the liver to the tissues c) A lipoprotein that contains relatively high amounts of cholesterol and is associated with an increased risk of atherosclerosis and coronary artery disease. It is also called beta-lipoprotein d) Large lipoprotein particle that is created by the absorptive cells of the small intestine. It transports lipids to adipose tissue where they are broken down by lipoprotein lipase

006. Hyperlipoproteinemia is a condition marked by an abnormally high level of lipoproteins in the blood. This consideration is: a) True b) False

007. Hypertriglyceridemia denotes high blood levels of triglycerides. It has been associated with atherosclerosis, even in the absence of hypercholesterolemia (high cholesterol levels). This consideration is: a) True b) False

008. Hypercholesterolemia (or hypercholesteremia) is an abnormally high concentration of cholesterol in the blood. This consideration is: a) True b) False

009. Which of the following consideration about type I familial hyperlipoproteinemia is True: a) Type I familial hyperlipoproteinemia marked by the increased serum concentrations of chylomicrons and triglycerides, which decrease if the diet becomes fat free, decreased concentrations of high- and low-density lipoproteins, which increase if the diet is fat free, and decreased tissue lipoprotein lipase activity b) Type I familial hyperlipoproteinemia characterized by increased serum concentrations of chylomicrons, pre-low-density lipoproteins, and triglycerides that are considered to be the result of a combination of fat and carbohydrate-induced hyperlipemia

010. Familial chylomicronemia (type I) is caused by deficiency in lipoprotein lipase activity. This consideration is: a) True b) False

011. The Coronary Primary Prevention Trial (CPPT) demonstrated that treatment with a lipid-lowering drug could reduce the risk of death due to coronary heart disease. This consideration is: a) True b) False

012. Women taking probucol (Lorelco) should wait for 6 months after cessation of therapy before becoming pregnant. This consideration is: a) True b) False

013. Nicotinic acid (Niacin) plus a bile acid-binding resin has not proven effective in combating hyperlipidemia. This consideration is: a) True b) False

014. The ideal therapy for patients with elevated levels of cholesterol would lower the serum concentration of LDL-cholesterol while raising the concentration of HDL-cholesterol. This consideration is: a) True b) False 015. Agents, which lower levels of LDL-cholesterol, tend to promote regression of atherosclerotic plaques. This consideration is: a) True b) False

016. Clofibrate (Atromid-S) is the drug of choice for treatment of broad-beta hyperlipidemia (type III). This consideration is: a) True b) False

017. One advantage of gemfibrozil (Lopid) is that, in addition to lowering blood levels of most lipids, it raises the level of HDL cholesterol. This consideration is: a) True b) False

018. Probucol (Lorelco) appears to increase clearance of LDL cholesterol by a non-receptor mediated mechanism. This consideration is: a) True b) False

019. All of the following statements concerning cholestyramine (Questran) are true, EXCEPT: a) It would not be a good choice for treating patients with familial hypertriglyceridemia (type IV) b) It is not well tolerated by patients c) It works by directly binding cholesterol in the blood d) It is an effective drug for treatment of types IIa and IIb hyperlipidemia

020. All of the following statements concerning drugs which inhibit cholesterol synthesis are true, EXCEPT: a) They work in part by increasing the rate of LDL clearance from the plasma b) They are the most effective single agents for lowering LDL-cholesterol c) When used with a bile-acid binding resin, they can lower LDL-cholesterol by 50% or more d) No special monitoring is required in patients receiving one of them

021. All of the following statements concerning nicotinic acid (Niacin) are true, EXCEPT: a) It reduces the rate of synthesis of VLDL b) Sustained-release preparations of this drug are largely free of side effects c) Almost all patients taking the traditional dosage form of this drug experience uncomfortable flushing d) It should not be used with antihypertensives

022. All of the following statements concerning drugs which inhibit cholesterol synthesis are true, EXCEPT: a) When used alone, they are the most effective agents for lowering LDL cholesterol b) They are often effective in patients in whom a diet, with or without a bile acid-binding resin or niacin, has failed c) Lovastatin (Mevacor) plus a resin causes regression of coronary lesions in about one third of treated patients
d) Members of this drug class are generally not as well tolerated as the older bile acid-binding resins

023. All of the following statements concerning drugs which inhibit cholesterol synthesis are true, EXCEPT: a) These drugs should not be used in pregnant women or children b) These drugs often cause myopathy if used in combination with cyclosporine (Sandimmune) c) Failure to discontinue the drug after myopathy has been detected can cause acute renal failure d) Several of these drugs tend to lengthen the sleep cycle

024. All of the following statements concerning the fibric acid derivatives are true, EXCEPT: a) Clofibrate (Atromid-S) is the drug of choice for therapy of Type III hyperlipidemia b) Gemfibrozil (Lopid) increases HDL cholesterol while lowering LDL cholesterol c) Gemfibrozil (Lopid) has been shown to reduce mortality associated with a heart disease d) Gemfibrozil (Lopid) is generally well tolerated

025. All of the following statements concerning the bile acid-binding resins are true, EXCEPT: a) They decrease total cholesterol and LDL b) They are contraindicated in patients with hypertriglyceridemia c) When used alone, they do not slow the progression of atherosclerotic lesions d) They are the drugs of choice for therapy of type II hyperlipidemia when used either alone or in combination with selected agents

026. All of the following statements concerning nicotinic acid (Niacin) are true, EXCEPT: a) Both triglycerides and LDL cholesterol are reduced by this drug b) The drug acts by directly decreasing the rate of synthesis of apoproteins c) Doses higher than 3 gm/day are no longer used because of possible disturbances of hepatic or pancreatic functions d) Most patients taking this drug experience uncomfortable cutaneous flushing, itching, and/or rashes

027. All of the following statements concerning the general principles of therapy with lipid-lowering drugs are true EXCEPT: a) Therapy with a lipid-lowering drug should be always accompanied by an appropriate diet b) A lipid-lowering diet should be discontinued if it fails to decrease the levels of plasma LDL cholesterol by at least 10% c) Lipid-lowering drugs should only be administered after at least 3 months of prior dietary therapy d) Some combinations of lipid-lowering drugs are synergistic

028. The cholesterol synthesis inhibitors increase the rate of clearance of LDL cholesterol from the plasma. This consideration is: a) True b) False

029. Lovastatin (Mevacor) plus a bile-acid binding resin causes regression of coronary lesions in about one third of treated patients. This consideration is: a) True b) False

030. The cholesterol synthesis inhibitors are better tolerated than most other lipid-lowering agents. This consideration is: a) True b) False

031. Selected liver and muscle enzymes should be monitored during the use of any cholesterol synthesis inhibitors because of possible toxic effects. This consideration is: a) True b) False

032. The bile acid-binding resins act by directly binding cholesterol and facilitating its excretion. This consideration is: a) True b) False

033. Nicotinic acid (Niacin) acts by increasing the rate of catabolism of VLDL. This consideration is: a) True b) False

034. Gemfibrozil (Lopid) can cause dizziness and syncope when used with antihypertensives. This consideration is: a) True b) False

035. Gemfibrozil (Lopid) increases concentrations of HDL cholesterol more than clofibrate (Atromid-S). This consideration is: a) True b) False

036. The bile acid-binding resins can bind many drugs and vitamins and reduce their absorption. This consideration is: a) True b) False

037. When used alone, the bile acid-binding resins are contraindicated in patients with hypertriglyceridemia. This consideration is: a) True b) False

038. Combinations of lipid-lowering drugs are likely to be synergistic if they work at different steps in the same pathway. This consideration is: a) True b) False

039. Reduction in plasma triglycerides and LDL cholesterol concentrations with gemfibrozil treatment is greater than reduction in plasma cholesterol and LDL cholesterol concentrations with gemfibrozil treatment. This consideration is: a) True b) False

040. Patients with homozygous familial hypercholesterolemia (type IIa) lack any functional LDL receptors on their hepatocytes. This consideration is: a) True b) False

041. Effects of drugs in lowering blood cholesterol levels are additive with those of diet. This consideration is: a) True b) False

042. HMG-CoA reductase inhibiting drugs can cause muscle breakdown, especially when used in combination with a cyclosporine. This consideration is: a) True b) False

043. Probucol (Lorelco) reduces the risk of atherosclerosis by stimulating the rate of clearance of LDL by receptor-mediated pathways. This consideration is: a) True b) False

044. Clofibrate (Atromid-S) is generally regarded as superior to gemfibrozil. a) True b) False

045. Niacin’s most common side effects can be reduced by pretreatment with aspirin and/or by taking the drug at the end of meals. This consideration is: a) True b) False

046. The major side effect of cholestyramine is hepatotoxicity. This consideration is: a) True b) False

047. The statins are dependent on the presence of LDL receptors on hepatocytes in order to exert their effect. This consideration is: a) True b) False

048. This drug increases lipoprotein lipase (LPL) activity in adipose tissue: a) Cholestyramine (Questran) b) Lovastatin (Mevacor) c) Nicotinic acid (Niacin) d) Gemfibrozil (Loprol)

049. This drug both inhibits an enzyme and indirectly enhances clearance of low density lipoproteins (LDL): a) Cholestyramine (Questran) b) Lovastatin (Mevacor) c) Nicotinic acid (niacin) d) Probucol (Lorelco)

050. This drug binds bile acids in the GI tract: a) Cholestyramine (Questran) b) Nicotinic acid (niacin) c) Gemfibrozil (Loprol) d) Probucol (Lorelco)

051. This drug may block oxidation of low density lipoproteins (LDL): a) Lovastatin (Mevacor) b) Nicotinic acid (niacin) c) Gemfibrozil (Loprol) d) Probucol (Lorelco)

052. This drug weakly stimulates synthesis of very low density lipoproteins (VLDL):
a) Cholestyramine (Questran) b) Lovastatin (Mevacor) c) Gemfibrozil (Loprol) d) Probucol (Lorelco)

053. Flushing caused by this drug can be reduced by taking it after meals and/or by pretreatment with aspirin: a) Lovastatin (Mevacor) b) Nicotinic acid (niacin) c) Gemfibrozil (Loprol) d) Probucol (Lorelco)

054. This drug can cause muscle damage, especially when used with any of several drugs including erythromycin: a) Cholestyramine (Questran) b) Lovastatin (Mevacor) c) Gemfibrozil (Loprol) d) Probucol (Lorelco)

055. This drug decreases blood levels of high density lipoproteins (HDL): a) Lovastatin (Mevacor) b) Nicotinic acid (niacin) c) Gemfibrozil (Loprol) d) Probucol (Lorelco)

056. This fibric acid derivative increases blood levels of high density lipoproteins (HDL): a) Cholestyramine (Questran) b) Lovastatin (Mevacor) c) Gemfibrozil (Loprol) d) Probucol (Lorelco)

057. Gout is a familial metabolic disease characterized by recurrent episodes of acute arthritis due to deposits of monosodium urate in joints and cartilage. This consideration is: a) True b) False

058. Probenecid and sulfinpyrazone are uricosuric drugs employed to decrease the body pool of urate in patients with tophaceous gout or in those with increasingly frequent gouty attacks. This consideration is: a) True b) False

059. Which of the following drugs is an uricosuric agent: a) Allopurinol b) Sulfinpyrazone c) Colchicine d) Indomethacin

060. Uricosuric drugs are the following, EXCEPT: a) Probenecid b) Sulfinpyrazone c) Colchicine d) Aspirin (at high dosages)

061. Which of the following drugs used in the treatment of gout acts by preventing the migration of granulocytes: a) Allopurinol b) Sulfinpyrazone c) Colchicine d) Indomethacin

062. Which of the following drugs used in the treatment of gout has as its primary effect the reduction of uric acid synthesis a) Allopurinol b) Sulfinpyrazone c) Colchicine d) Indomethacin

063. Characteristics of probenecid include all of the following, EXCEPT: a) It promotes the renal tubular secretion of penicillin b) It is useful in the treatment of gout c) At appropriate doses, it promotes the excretion of uric acid d) The metabolic products of probenecid are uricosuric

 

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