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A review of the evidence

doi: 10.1097/01.NPR.0000546536.05354.f7
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INSTRUCTIONS Hypertriglyceridemia: A review of the evidence


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Hypertriglyceridemia: A review of the evidence

Purpose: To provide information on the diagnosis and management of patients with hypertriglyceridemia. Learning Objectives/Outcomes: After completing this continuing-education activity, you should be able to: 1. Examine the diagnosis of and risk factors for hypertriglyceridemia. 2. Select management options for patients with hypertriglyceridemia.

  1. According to the AHA guidelines, TG levels are considered high if they are
    1. 150 to 199 mg/dL.
    2. 200 to 499 mg/dL.
    3. ≥500 mg/dL.
  2. A lab test used to help exclude alcohol abuse as a secondary cause of hypertriglyceridemia is
    1. serum creatinine.
    2. mean cell volume.
    3. non-HDL cholesterol.
  3. According to the AACE/ACE joint guidelines, how often should adults older than 20 years be evaluated for dyslipidemia as part of a global risk assessment?
    1. every year
    2. every 2 years
    3. every 5 years
  4. A cardiovascular risk component of metabolic syndrome includes
    1. reduced HDL-C ≤ 60 in women.
    2. elevated TG ≥ 150 mg/dL.
    3. elevated waist circumference ≥ 33 in for non-Asian women.
  5. Which form of estrogen can increase TG levels?
    1. oral
    2. topical transdermal
    3. vaginal
  6. Patients with high TGs should be screened for
    1. HIV infection.
    2. adrenal insufficiency.
    3. hypothyroidism.
  7. Which of the following beta-adrenergic blockers tends to cause the lowest increase in TG levels?
    1. carvedilol
    2. atenolol
    3. metoprolol
  8. Which antipsychotic medication is more likely to cause hypertriglyceridemia?
    1. aripiprazole
    2. risperidone
    3. ziprasidone
  9. Which statement is correct regarding hypertriglyceridemia?
    1. The diagnosis of hypertriglyceridemia may be made using fasting or nonfasting lipid levels.
    2. Eruptive xanthomas from hypertriglyceridemia are usually seen on the face.
    3. Most patients with hypertriglyceridemia are completely asymptomatic until reaching severe or very severe levels.
  10. Which nutrition practice typically results in the greatest lowering of TG levels?
    1. losing 5% to 10% of body weight
    2. adding marine-derived polyunsaturated fatty acids
    3. implementing the Mediterranean-style diet
  11. As noted in the article, if patients remain on very low-fat diets for an extended period, essential fatty acids should be supplemented with any of the following except
    1. walnut oil.
    2. sunflower oil.
    3. palm kernel oil.
  12. The primary treatment for hypertriglyceridemia is
    1. long-chain omega-3 fatty acids.
    2. proprotein convertase subtilisin/kexin type 9 inhibitors.
    3. lifestyle modifications.
  13. Which lipid-lowering medication typically is the least effective in reducing TG levels?
    1. cholesterol absorption inhibitors
    2. fibric acids
    3. nicotinic acid
  14. What is often one of the first-line medical treatment options to mitigate the risk of pancreatitis in patients with very high TG levels?
    1. statins
    2. fibrates
    3. long-chain omega-3 fatty acids
  15. Which of the following is a potential adverse reaction associated with fibrate therapy?
    1. hyperuricemia
    2. blurred vision
    3. cholelithiasis
  16. Which drug is associated with severe adverse reactions when combined with statins?
    1. EPA
    2. gemfibrozil
    3. volanesorsen
  17. The most common adverse reaction from niacin is
    1. hypoglycemia.
    2. edema.
    3. cutaneous vasodilation.
  18. The authors note that pioglitazone has a limited use in lipid management secondary to adverse reactions that include an increased risk of
    1. bladder cancer.
    2. hyperuricemia.
    3. pruritus.


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