Lipid Management: ABFM practice questions

12 board-style questions on lipid management in the PulseMD family medicine question bank — physician-reviewed, written against current guidelines with the reference cited on each question. Two free samples below; the full set with answers, explanations, and spaced review is free to start.

Sample question 1

A 50-year-old man with type 2 diabetes diagnosed 12 years ago presents for cardiovascular risk assessment. His LDL is 138 mg/dL and he has no known cardiovascular disease. Additional findings include microalbuminuria (urine albumin-to-creatinine ratio 82 mg/g), mild non-proliferative diabetic retinopathy, and an ABI of 0.92. His 10-year ASCVD risk is calculated at 22%. According to ACC/AHA cholesterol guidelines, what statin intensity is recommended?

1. No statin is needed since LDL is below 190 mg/dL and he has no known ASCVD
2. Low-intensity statin therapy
3. Moderate-intensity statin therapy
4. High-intensity statin therapy to reduce LDL by at least 50%

Sample question 2

A 63-year-old man has been on atorvastatin 40 mg daily for 8 months for primary prevention of ASCVD. He reports diffuse myalgias in his thighs and calves that began about 6 weeks ago. He denies muscle weakness, dark-colored urine, or fever. Physical exam shows no focal tenderness or weakness. CK level is 185 U/L (normal less than 200 U/L). LFTs are normal. What is the most appropriate management?

1. Discontinue atorvastatin permanently and never rechallenge with any statin
2. Trial of a lower dose or alternative statin (e.g., rosuvastatin or pravastatin) with symptom monitoring
3. Add coenzyme Q10 supplementation and continue the current dose of atorvastatin
4. Order a muscle biopsy to rule out statin-induced necrotizing myopathy

Create a free PulseMD account to answer these, see the explanations, and practice five minutes a day.

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