CCRP AACVPR 2026 ALL QUESTIONS AND ANSWERS SURE
A+
✔✔fibrous plaque - ✔✔when fatty streak(plaque) grows and enlarges enough to narrow
the lumen/opening of the blood vessel and limits blood flow
✔✔fibrous plaque consists of - ✔✔outer fibrous cap and inner lipid core
✔✔reduced coronary blood flow (myocardial ischemia) resulting from fibrous plaques
contributes to symptoms of ______ and ______ - ✔✔angina; dyspnea
✔✔__________ inside of plaque can promote breakdown and rupture of fibrous plaque
- ✔✔inflammatory changes
✔✔plaque that is more prone to rupture _______; which doesn't cause ____ -
✔✔younger, more immature; luminal narrowing (aka no symptoms)
✔✔what happens after plaque rupture - ✔✔clot formation within the lumen of the artery
and potentially resulting in acute coronary syndrome from sudden obstruction to
coronary blood flow (acute myocardial ischemia)
✔✔acute coronary syndrome - ✔✔acute MI, unstable angina, sudden cardiac death that
occurs as a consequence of ischemia induced fatal ventricular arrhythmias
✔✔coronary plaques that have high ______and a large ______ are more inflammatory
and susceptible to acute rupture - ✔✔cholesterol content; lipid core (soft plaques)
✔✔diets high in ___ and ____ elevate LDL - ✔✔fat and cholesterol
✔✔replace sat fat and trans fat for _____ and ____ to reduce LDL - ✔✔MUFA and
PUFA
✔✔dietary cholesterol food examples - ✔✔animal products - meat, poultry, fish, eggs,
butter, cheese, whole milk, 2% milk
✔✔sat fat examples - ✔✔high fat meats, dairy products, and tropical oils
✔✔trans fat examples - ✔✔fried foods, baked goods, stick margarines, shortenings
✔✔MUFA examples - ✔✔Nuts and seeds, avocado, vegetable oils (canola, olive,
sunflower, peanut)
,✔✔PUFA examples - ✔✔vegetable oils (soybean, corn, safflower), fatty fish, nuts, and
seeds
✔✔diet to lower LDL - ✔✔-fruits, veggies, whole grains
-low fat dairy, fish, legumes, non-tropical vegetable oils, nuts
-limit sweets, sugar-sweetened bevs, and red meat
-5-6% of cals from sat fat
-reduce percentage of cals from sat and trans fat
✔✔aerobic physical activity can lower __ - ✔✔LDL and non-HDL
✔✔resistance training can lower - ✔✔LDL, TG, non HDL-C
✔✔PA recommendations for lowering LDL and non-HDL-C - ✔✔3-4 sessions per week
of aerobic PA of moderate to vigorous intensity lasting on avg 40 min per session
✔✔other lifestyle recommnadations to improve cholesterol - ✔✔smoking cessation,
healthy BW, moderate alcohol consumption
✔✔secondary causes of dyslipidemia - elevated LDL - ✔✔high sat/trans fat diet
weight gain
anorexia
diuretics
cyclosporine
glucocorticoids
amiodarone
biliary obstruction
nephrotic syndrome
hypothyroidism
obesity
pregnancy
✔✔secondary causes of dyslipidemia - elevated TG - ✔✔diets high in refined carbs
weight gain
very low fat diets
excessive alcohol intake
estrogens
glucocorticoids
bile acid sequestrants
protease inhibitors
retinoic acid
anabolic steroids
sirolimus
beta blockers
thiazide diuretics
,chronic renal failure
nephrotic syndrome
diabetes
hypothyroidism
obesity
pregnancy
✔✔rosuvastatin (Crestor) moderate intensity - ✔✔5, 10 mg
✔✔rosuvastatin (crestor) high intensity - ✔✔20 mg, 40 mg
✔✔atorvastatin (Lipitor) moderate intensity - ✔✔10 mg, 20 mg
✔✔atorvastatin (Lipitor) high intensity - ✔✔40, 80 mg
✔✔simvastatin (Zocor) low intensity dose - ✔✔10 mg
✔✔simvastatin (Zocor) moderate intensity - ✔✔20, 40 mg
✔✔pravastatin (pravachol) low intensity - ✔✔10, 20 mg
✔✔pravastatin moderate intensity - ✔✔40, 80 mg
✔✔lovastatin low intensity - ✔✔20 mg
✔✔lovastatin moderate intensity - ✔✔40 mg
✔✔fluvastatin XL moderate intensity - ✔✔80 mg
✔✔fluvastatin low intensity - ✔✔20, 40 mg
✔✔fluvastatin moderate intensity - ✔✔40 mg BID
✔✔pitavastatin low intensity - ✔✔1 mg
✔✔pitavastatin moderate intensity - ✔✔2, 4 mg
✔✔higher intensity dose of statin for - ✔✔higher risk
✔✔four groups that benefit from statins - ✔✔-clinical ASCVD
-LDL >190 mg/dL
-diabetes, aged 40-75 years, 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%
, ✔✔LDL >190 mg/dL statin dose - ✔✔high intensity
✔✔clinical ASCVD statin dose - ✔✔-high intensity for those <75 yo
-moderate intensity for those >75 yo
✔✔diabetes, aged 40-75 years, LDL 70-189 and no clinical ASCVD statin dose -
✔✔moderate intensity statin dose
-if 10 year risk of ASCVD >7.5% optitional use of high intensity statin
-consideration of statin in those <40 and >75 years
✔✔aged 45-70, LDL 70-189, no diabetes or clinical ASCVD, and 10 year risk for
ASCVD >7.5% statin dose - ✔✔moderate to high intensity statin
✔✔recommended lipid profile ____ weeks after start of statin and ______ months
thereafter - ✔✔4-12; 3-12
✔✔if patients have adverse reaction to statin - ✔✔alternative statin or lower dose may
help
✔✔glucose enters blood stream from the ______ and travels to - ✔✔GI tract; all cells of
the body
✔✔when glucose levels in the blood stream rise, the pancreas releases ______ -
✔✔insulin
✔✔insulin - ✔✔A protein hormone secreted by the pancreas that is essential for the
metabolism of carbohydrates and the regulation of glucose levels in the blood.
✔✔elevated serum glucose stimulate insulin _______ and ______ - ✔✔synthesis and
secretion
✔✔once insulin is secreted into circulation, it binds to ______ which facilatates _______
and lowers _______ - ✔✔cell surface receptors; glucose uptake from the blood into the
cell for use as energy source; blood glucose
✔✔if the pancreas loses its ability to maintain high levels of insulin production, that
leads to - ✔✔insulin deficiency and further rises in blood glucose levels
✔✔type 1 diabetes - ✔✔complete or nearly complete insulin deficiency as a result of
autoimmune B cell destruction in the pancreas
A+
✔✔fibrous plaque - ✔✔when fatty streak(plaque) grows and enlarges enough to narrow
the lumen/opening of the blood vessel and limits blood flow
✔✔fibrous plaque consists of - ✔✔outer fibrous cap and inner lipid core
✔✔reduced coronary blood flow (myocardial ischemia) resulting from fibrous plaques
contributes to symptoms of ______ and ______ - ✔✔angina; dyspnea
✔✔__________ inside of plaque can promote breakdown and rupture of fibrous plaque
- ✔✔inflammatory changes
✔✔plaque that is more prone to rupture _______; which doesn't cause ____ -
✔✔younger, more immature; luminal narrowing (aka no symptoms)
✔✔what happens after plaque rupture - ✔✔clot formation within the lumen of the artery
and potentially resulting in acute coronary syndrome from sudden obstruction to
coronary blood flow (acute myocardial ischemia)
✔✔acute coronary syndrome - ✔✔acute MI, unstable angina, sudden cardiac death that
occurs as a consequence of ischemia induced fatal ventricular arrhythmias
✔✔coronary plaques that have high ______and a large ______ are more inflammatory
and susceptible to acute rupture - ✔✔cholesterol content; lipid core (soft plaques)
✔✔diets high in ___ and ____ elevate LDL - ✔✔fat and cholesterol
✔✔replace sat fat and trans fat for _____ and ____ to reduce LDL - ✔✔MUFA and
PUFA
✔✔dietary cholesterol food examples - ✔✔animal products - meat, poultry, fish, eggs,
butter, cheese, whole milk, 2% milk
✔✔sat fat examples - ✔✔high fat meats, dairy products, and tropical oils
✔✔trans fat examples - ✔✔fried foods, baked goods, stick margarines, shortenings
✔✔MUFA examples - ✔✔Nuts and seeds, avocado, vegetable oils (canola, olive,
sunflower, peanut)
,✔✔PUFA examples - ✔✔vegetable oils (soybean, corn, safflower), fatty fish, nuts, and
seeds
✔✔diet to lower LDL - ✔✔-fruits, veggies, whole grains
-low fat dairy, fish, legumes, non-tropical vegetable oils, nuts
-limit sweets, sugar-sweetened bevs, and red meat
-5-6% of cals from sat fat
-reduce percentage of cals from sat and trans fat
✔✔aerobic physical activity can lower __ - ✔✔LDL and non-HDL
✔✔resistance training can lower - ✔✔LDL, TG, non HDL-C
✔✔PA recommendations for lowering LDL and non-HDL-C - ✔✔3-4 sessions per week
of aerobic PA of moderate to vigorous intensity lasting on avg 40 min per session
✔✔other lifestyle recommnadations to improve cholesterol - ✔✔smoking cessation,
healthy BW, moderate alcohol consumption
✔✔secondary causes of dyslipidemia - elevated LDL - ✔✔high sat/trans fat diet
weight gain
anorexia
diuretics
cyclosporine
glucocorticoids
amiodarone
biliary obstruction
nephrotic syndrome
hypothyroidism
obesity
pregnancy
✔✔secondary causes of dyslipidemia - elevated TG - ✔✔diets high in refined carbs
weight gain
very low fat diets
excessive alcohol intake
estrogens
glucocorticoids
bile acid sequestrants
protease inhibitors
retinoic acid
anabolic steroids
sirolimus
beta blockers
thiazide diuretics
,chronic renal failure
nephrotic syndrome
diabetes
hypothyroidism
obesity
pregnancy
✔✔rosuvastatin (Crestor) moderate intensity - ✔✔5, 10 mg
✔✔rosuvastatin (crestor) high intensity - ✔✔20 mg, 40 mg
✔✔atorvastatin (Lipitor) moderate intensity - ✔✔10 mg, 20 mg
✔✔atorvastatin (Lipitor) high intensity - ✔✔40, 80 mg
✔✔simvastatin (Zocor) low intensity dose - ✔✔10 mg
✔✔simvastatin (Zocor) moderate intensity - ✔✔20, 40 mg
✔✔pravastatin (pravachol) low intensity - ✔✔10, 20 mg
✔✔pravastatin moderate intensity - ✔✔40, 80 mg
✔✔lovastatin low intensity - ✔✔20 mg
✔✔lovastatin moderate intensity - ✔✔40 mg
✔✔fluvastatin XL moderate intensity - ✔✔80 mg
✔✔fluvastatin low intensity - ✔✔20, 40 mg
✔✔fluvastatin moderate intensity - ✔✔40 mg BID
✔✔pitavastatin low intensity - ✔✔1 mg
✔✔pitavastatin moderate intensity - ✔✔2, 4 mg
✔✔higher intensity dose of statin for - ✔✔higher risk
✔✔four groups that benefit from statins - ✔✔-clinical ASCVD
-LDL >190 mg/dL
-diabetes, aged 40-75 years, 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%
, ✔✔LDL >190 mg/dL statin dose - ✔✔high intensity
✔✔clinical ASCVD statin dose - ✔✔-high intensity for those <75 yo
-moderate intensity for those >75 yo
✔✔diabetes, aged 40-75 years, LDL 70-189 and no clinical ASCVD statin dose -
✔✔moderate intensity statin dose
-if 10 year risk of ASCVD >7.5% optitional use of high intensity statin
-consideration of statin in those <40 and >75 years
✔✔aged 45-70, LDL 70-189, no diabetes or clinical ASCVD, and 10 year risk for
ASCVD >7.5% statin dose - ✔✔moderate to high intensity statin
✔✔recommended lipid profile ____ weeks after start of statin and ______ months
thereafter - ✔✔4-12; 3-12
✔✔if patients have adverse reaction to statin - ✔✔alternative statin or lower dose may
help
✔✔glucose enters blood stream from the ______ and travels to - ✔✔GI tract; all cells of
the body
✔✔when glucose levels in the blood stream rise, the pancreas releases ______ -
✔✔insulin
✔✔insulin - ✔✔A protein hormone secreted by the pancreas that is essential for the
metabolism of carbohydrates and the regulation of glucose levels in the blood.
✔✔elevated serum glucose stimulate insulin _______ and ______ - ✔✔synthesis and
secretion
✔✔once insulin is secreted into circulation, it binds to ______ which facilatates _______
and lowers _______ - ✔✔cell surface receptors; glucose uptake from the blood into the
cell for use as energy source; blood glucose
✔✔if the pancreas loses its ability to maintain high levels of insulin production, that
leads to - ✔✔insulin deficiency and further rises in blood glucose levels
✔✔type 1 diabetes - ✔✔complete or nearly complete insulin deficiency as a result of
autoimmune B cell destruction in the pancreas
