Ccrp Aacvpr Updated Exams Script Questions And Answers Sure A.pdf

CCRP AACVPR UPDATED EXAMS SCRIPT QUESTIONS AND
ANSWERS SURE A+
✔✔ACC/AHA Lifestyle Management Guidelines Dietary recommendations for lowering
LDL-C - ✔✔1) consume a dietary pattern that emphasizes; vegetables, whole grains
and fruits; low fat dairy products, fish, legumes, non-tropical oils and nuts; limit sweets,
sugared beverages and red meats
2) Aim for a diet of 5-6% of calories from saturated fats
3) Reduce percent calories from saturated fats
4) Reduce percent of calories from trans fats

✔✔What are unrefined carbohydrates referred as - ✔✔whole grains

✔✔Strongest evidence for dietary patterns - ✔✔DASH diet
(dietary approach to stop hypertension)

✔✔Function of statins - ✔✔reduce cholesterol production in the liver by inhibiting the
enzyme HMG CoA reductase

✔✔When to investigate into possible secondary causes of hyperlipidemia - ✔✔LDL-C
>190 mg/dL and triglycerides >600mg/dL

✔✔LDL-C reduction on low intensity statin - ✔✔<30%

✔✔LDL-C reduction on moderate intensity statin - ✔✔30-<50%

✔✔LDL-C reduction on high intensity statin - ✔✔>50%

✔✔Secondary causes of elevated LDL - ✔✔diets high in saturated fat/trans fat, weight
gain, anorexia, diuretics, cyclosporine, glucocorticoids, amiodarone, binary obstruction,
nephrotic syndrome, hypothyroidism, obesity, pregnancy

✔✔Secondary causes of elevated triglycerides - ✔✔Diets high in refined carbs, weight
gain, very low fat diets, excessive alcohol intake, estrogens, glucocorticoids, bile acid
sequestrates, protease inhibitors, retinoid acid, anabolic steroids, sirolimus, ralozifene,
tamoxifen, beta blockers, thiazide diuretics, chronic renal failure, nephrotic syndrome,
lipodystrophies, diabetes, hypothyroidism, obesity, pregnancy

✔✔Rosuvastatin 5, 10mg intensity - ✔✔moderate

✔✔Rosuvastatin 20, 40 mg intensity - ✔✔high

✔✔Atorvastatin 10, 20 mg intensity - ✔✔moderate

,✔✔Atorvastatin 40, 80mg intensity - ✔✔high

✔✔Simvastatin 10mg intensity - ✔✔low

✔✔Simvastatin 20, 40 mg intensity - ✔✔moderate

✔✔Pravastatin 10, 20 mg intensity - ✔✔low

✔✔Pravastatin 40, 80mg intensity - ✔✔moderate

✔✔Lovastatin 20mg intensity - ✔✔low

✔✔Lovastatin 40mg intensity - ✔✔moderate

✔✔Fluvastatin XL 80mg intensity - ✔✔moderate

✔✔Fluvastatin 20, 40mg intensity - ✔✔low

✔✔Fluvastatin 40 mg BID intensity - ✔✔moderate

✔✔Pitavastatin 1mg intensity - ✔✔low

✔✔Pitavastatin 2, 4mg intensity - ✔✔moderate

✔✔Moderate - High intensity Statins - ✔✔Rosuvastatin, Atorvastatin

✔✔Low-Moderate intensity Statin - ✔✔Simvastatin
Pravastatin
Lovastatin
Fluvastatin
Pitavastatin

✔✔What is the decision based on about whether to initiate statin therapy and what dose
- ✔✔based on an individuals global CVD risk rather than LDL level

✔✔Reassessment recommendations of lipid profile repeating - ✔✔repeat in 4-12 weeks
after initiation of statin therapy and 3-12 months periodically thereafter to access for the
expected response to therapy

✔✔Four clinical groups that benefit from statin therapy - ✔✔-Clinical ASCVD
-LDL-C ≥190
-Diabetes, aged 40-75, LDL 70-189 and no clinical ASCVD
-Aged 45-70, LDL 70-189, no diabetes or clinical ASCVD and 10 year risk for ASCVD
≥7.5%

,✔✔Intensity of statin recommended for groups with Clinical ASCVD - ✔✔High intensity
for those ≤75
Moderate intensity for those >75

✔✔Intensity of statin recommended for groups with LDL ≥190 - ✔✔High intensity

✔✔Intensity of statin recommended for groups with Diabetes, aged 40-75, LDL 70-189
and no clinical ASCVD - ✔✔Moderate intensity
*If 10 year risk ≥7.5%, option use of high intensity

✔✔Intensity of statin recommended for groups with Ages 45-70, LDL 70-189, no DM, or
clinical ASCVD and 10 year risk for ASCVD ≥7.5% - ✔✔Moderate to high intensity

✔✔Clinical ASCVD - ✔✔- acute coronary syndrome
- history of MI
- stable or unstable angina
- coronary or other arterial revascularization
- stroke/TIA
- peripheral artery disease

✔✔Two most common reasons the result in non-adherance to statin therapy -
✔✔Muscle side effects and transaminitis

✔✔Lipid effects of Niacin - ✔✔flushing, transaminitis, hyperglycemia, hyperuricemia

✔✔Lipid effects of bile acid sequestrates - ✔✔hypertriglycermia

✔✔Lipid effects of cholesterol absorption inhibitors - ✔✔transaminitis

✔✔Lipid effects of vibrates - ✔✔myopathy, renal dysfunction

✔✔Lipid effects of omega 3 ftty acids - ✔✔DI disturbances, skin changes, bleeding

✔✔Transaminitis - ✔✔having high levels of certain liver enzymes called transaminases.

✔✔Myalgias - ✔✔muscle pain

✔✔Rhabdomyolysis - ✔✔-condition in which damaged skeletal muscle breaks down
rapidly (caused by trauma, extreme exertion, or drug toxicity; in severe cases renal
failure can result)
-death of muscle fibers and release of their contents into the bloodstream.

✔✔What type of contraindication: Recent changes in ECG - ✔✔absolute

, ✔✔What type of contraindication: unstable angina - ✔✔absolute

✔✔What type of contraindication: uncontrolled cardiac arrhythmias - ✔✔absolute

✔✔What type of contraindication: symptomatic severe aortic stenosis or other valvular
disease - ✔✔absolute

✔✔What type of contraindication: decompensated symptomatic heart failure -
✔✔absolute

✔✔What type of contraindication: acute PE or pulmonary infarction - ✔✔absolute

✔✔What type of contraindication: acute non cardiac disorder that may affect exercise
performance or may be aggravated by exercise (infection,thyrotoxisosis) - ✔✔absolute

✔✔What type of contraindication: acute myocarditis or pericarditis - ✔✔absolute

✔✔What type of contraindication: acute thrombophlebitis - ✔✔absolute

✔✔What type of contraindication: physical disability that would preclude safe and
adequate exercise performance - ✔✔absolute

✔✔What type of contraindication: electrolyte abnormalities - ✔✔relative

✔✔What type of contraindication: tachyarrhythmias or bradyarrhythmias - ✔✔relative

✔✔What type of contraindication: high degree atrioventricular block - ✔✔relative

✔✔What type of contraindication: atrial fibrillation with uncontrolled rate - ✔✔relative

✔✔What type of contraindication: hypertrophic obstructive cardiomyopathy with peak
resting left ventricular outflow gradient of >25mmHg - ✔✔relative

✔✔What type of contraindication: known aortic dissection - ✔✔relative

✔✔What type of contraindication: severe resting arterial HTN (SBP >200 and DBP
>100) - ✔✔relative

✔✔What type of contraindication: mental impairments leading to inability to cooperate
with testing - ✔✔relative