CLS Study Guide 2026

Everything you need to pass the CLS exam in one place: the exam format, every topic to study, real practice questions with explanations, flashcards, and full-length practice tests. Free, no sign-up needed.

๐Ÿ“‹ CLS Exam Format at a Glance

150
Questions
180 min
Time Limit
70%
Passing Score

๐Ÿ“š CLS Topics to Study (69)

Cardiovascular Risk Assessment & Management ยท 9 cardsDiagnosis & Classification of Dyslipidemia ยท 9 cardsLipid Metabolism & Physiology ยท 9 cardsTherapeutic Lifestyle & Pharmacologic Interventions ยท 9 cardsCardiovascular Risk Assessment & Management ยท 7 cardsCardiovascular Risk Assessment & Management ยท 7 cardsCardiovascular Risk Assessment & Management ยท 7 cardsCardiovascular Risk Assessment & Management ยท 7 cardsDiagnosis & Classification of Dyslipidemia ยท 7 cardsDiagnosis & Classification of Dyslipidemia ยท 7 cardsDiagnosis & Classification of Dyslipidemia ยท 7 cardsDiagnosis & Classification of Dyslipidemia ยท 7 cardsFamilial Hypercholesterolemia Management ยท 7 cardsFamilial Hypercholesterolemia Management ยท 7 cardsFamilial Hypercholesterolemia Management ยท 7 cardsFamilial Hypercholesterolemia Management ยท 7 cardsLifestyle Modification & Nutrition Counseling ยท 7 cardsLifestyle Modification & Nutrition Counseling ยท 7 cardsLifestyle Modification & Nutrition Counseling ยท 7 cardsLifestyle Modification & Nutrition Counseling ยท 7 cardsLipid Metabolism & Physiology ยท 7 cardsLipid Metabolism & Physiology ยท 7 cardsLipid Metabolism & Physiology ยท 7 cardsLipid Metabolism & Physiology ยท 7 cardsLipid Panel Interpretation ยท 7 cardsLipid Panel Interpretation ยท 7 cardsLipid Panel Interpretation ยท 7 cardsLipid Panel Interpretation ยท 7 cardsNon-Statin Lipid-Lowering Pharmacotherapy ยท 7 cardsNon-Statin Lipid-Lowering Pharmacotherapy ยท 7 cards

โœ๏ธ Sample CLS Questions & Answers

1. The mechanism by which evolocumab reduces LDL-C in HeFH patients includes which of the following?
โœ“ Binding circulating PCSK9, preventing it from degrading LDL receptors

Evolocumab is a monoclonal antibody that binds PCSK9 in plasma, preventing PCSK9 from binding and targeting LDL receptors for lysosomal degradation, thereby increasing receptor recycling.

2. What is the Friedewald equation limitation regarding triglycerides when calculating LDL-C?
โœ“ It is inaccurate when triglycerides exceed 400 mg/dL

The Friedewald equation (LDL = TC โˆ’ HDL โˆ’ TG/5) becomes unreliable when triglycerides exceed 400 mg/dL because the VLDL estimate is inaccurate.

3. What role does smoking cessation play in cardiovascular risk?
โœ“ Reduces cardiovascular risk

Smoking cessation significantly reduces cardiovascular risk by improving endothelial function, decreasing inflammation, and lowering blood pressure and heart rate. Within just a few years of quitting, the risk of heart attack and stroke drops substantially, eventually approaching that of a non-smoker. It is one of the most impactful lifestyle changes for cardiovascular health.

4. Which fibrateโ€“statin combination carries the greatest risk of severe myopathy and rhabdomyolysis?
โœ“ Gemfibrozil + any statin

Gemfibrozil inhibits the glucuronidation pathway responsible for statin metabolism, raising statin plasma concentrations significantly and increasing the risk of myopathy and rhabdomyolysis; fenofibrate does not share this interaction.

5. Which omega-3 fatty acid formulation is FDA-approved at prescription doses specifically for severe hypertriglyceridemia (โ‰ฅ500 mg/dL)?
โœ“ Icosapentaenoic acid (EPA) ethyl esters (Vascepa) and omega-3-acid ethyl esters (Lovaza)

Both Vascepa (pure EPA) and Lovaza (EPA+DHA) are FDA-approved prescription omega-3 formulations for triglycerides โ‰ฅ500 mg/dL.

6. Anorexia nervosa is associated with which lipid pattern?
โœ“ Elevated total cholesterol and LDL-C with reduced bile acid excretion

Anorexia nervosa often paradoxically raises LDL-C and total cholesterol due to reduced bile acid production, decreased LDL receptor activity, and impaired reverse cholesterol transport.

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CLS Study Guide 2026 โ€” Exam Format, Topics & Practice Questions