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Hypertension and Dyslipidemia Therapy Flashcards

7 cards from real BCACP practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. Which PCSK9 inhibitor is FDA-approved as a twice-yearly subcutaneous injection for LDL reduction?

    Answer: Inclisiran

    Inclisiran is an siRNA that inhibits PCSK9 synthesis and is dosed subcutaneously at baseline, 3 months, then every 6 months.

  2. A patient with hypertension and gout flares is on hydrochlorothiazide. What is the most appropriate change?

    Answer: Switch to losartan

    Losartan has a uricosuric effect that makes it the preferred antihypertensive in patients with gout, and switching from a thiazide reduces uric acid elevation.

  3. Which lipid-lowering drug is most associated with flushing as a side effect and requires premedication with aspirin?

    Answer: Niacin (nicotinic acid)

    Niacin causes prostaglandin-mediated cutaneous flushing; taking 325 mg aspirin 30 minutes before the dose significantly reduces this effect.

  4. A 70-year-old patient is on simvastatin 40 mg and is newly started on amlodipine. What drug interaction concern exists?

    Answer: Amlodipine inhibits CYP3A4 and increases simvastatin exposure

    Amlodipine weakly inhibits CYP3A4 and can modestly increase simvastatin plasma levels, potentially increasing myopathy risk.

  5. According to ACC/AHA guidelines, what is the LDL goal for a very high-risk ASCVD patient on maximally tolerated statin therapy?

    Answer: <55 mg/dL

    For very high-risk ASCVD patients (multiple major events or one major event plus multiple high-risk conditions), the 2022 ACC/AHA guidelines suggest an LDL goal of <55 mg/dL.

  6. Which antihypertensive is the preferred choice in a patient with hypertension and heart failure with reduced ejection fraction (HFrEF)?

    Answer: Carvedilol

    Carvedilol, a non-selective beta-blocker with alpha-1 blocking activity, is a guideline-directed medical therapy for HFrEF and also lowers blood pressure.

  7. A patient with hypertension and bilateral renal artery stenosis is being considered for antihypertensive therapy. Which drug class should be AVOIDED?

    Answer: ACE inhibitors

    ACE inhibitors in bilateral renal artery stenosis can precipitate acute renal failure by eliminating angiotensin II–dependent efferent arteriolar tone, the only mechanism maintaining filtration pressure.