MSN 624 LATEST 2026 STUDY GUIDE QUESTIONS AND
SOLUTIONS GRADED A+
✔✔Niacin - ✔✔- 150mg daily initially
- increase by 250mg/day increments every 4-7 days to 1.5-3g/day given in 2-3 divided
doses
- after 2 months increase by 500mg/day increments every 2-4 weeks according to
response, ma 4.5g/day
✔✔Cholestryamine - ✔✔4g daily or BID (max 24g/day)
✔✔Colestipol - ✔✔-5g daily o rBID initially
- increase by 5g/day increments every 1-2 months according to response max of
30g/day
✔✔Colesevelam - ✔✔3.75g/day given in 1-2 divided doses
✔✔Lipid Panel Monitoring - ✔✔- monitor every 6 weeks initially until LDL target is
achieved
- can extend to every 6-12 months once lipid levels have stabilized
- Lipids, glucose, LFTs, and uric acid are checked 6 weeks after beginning niacin or bile
acid sequestrants
✔✔Advise MD of the Following with Hyperlipidemia - ✔✔- unusual fatigue
- loss of appetite
- upper abdominal pain
- dark colored urine
- yellowing of skin/sclera
✔✔Metabolic Syndrome Conditions - ✔✔1. Type II Diabetes (insulin resistance,
hyperinsulinemia)
2. Abdominal Obesity
3. Hyperlipidemia (reduced HDL, elevated trigs and LDL)
4. Hypertension
✔✔Metabolic Syndrome Causes - ✔✔- genetic predisopositino
- sedentary lifestyle
- overnutrition
- morbid obesity
- high saturated fats and carbs
- steroids
- antidepressants
- antipsychotics
✔✔Metabolic Syndrome Diagnostic Criteria - ✔✔- elevated waist circumference
, - elevated triglycerides >150
- reduced HDL cholesterol <40 for men or <50 for women
- elevated BP (SBP >130, DBP >85 or current treatment for HTN)
- elevated fasting glucose > 100
- may see acanthoses nigricans in neck/axilla
✔✔Metabolic Syndrome Treatment - ✔✔- BP control (ACE, alpha-adrenergic
antagonists)
- Glucose reduction (metformin)
- Targeting LDL cholesterol and non-HDL cholesterol (statins)
- Lifestyle interventions (diet low in saturated fats, physical activity, weightloss)
✔✔Syncope - ✔✔- temporary loss of consciousness and tone followed by spontaneous
recovery, NO resuscitation needed
- often multifactorial
- similar incidence in women and men but increased incidence in women after age 70
✔✔Pre-Syncope - ✔✔sensation of lightheadedness/faintness felt which could lead to
syncope without LOC
✔✔Syncope Cardiac Causes - ✔✔- cardiac valvular disease
- pulmonary HTN
- pulmonary embolism
- pericardial disease
- cardiac tamponade
- MI
- ischemia
✔✔Syncope Arrhythmia Causes - ✔✔- sick sinus syndrome
- AV conduction disturbances
- pacemaker malfunction
- supra-ventricular or v-tach
- prolonged or shortened QT intervals
✔✔Syncope Neurologic Causes - ✔✔- autonomic failure
- vasovagal maneuver (common faint)
- situational (cough, swallow, defacation)
- carotid sinus sensitivity
✔✔Syncope Cerebrovascular Causes - ✔✔TIA
✔✔Syncope Miscellaneous Causes - ✔✔- hypoglycemia
- hypovolemia
- postprandial hypotension
- psychiatric disorders (panic, hysteria, depression)
SOLUTIONS GRADED A+
✔✔Niacin - ✔✔- 150mg daily initially
- increase by 250mg/day increments every 4-7 days to 1.5-3g/day given in 2-3 divided
doses
- after 2 months increase by 500mg/day increments every 2-4 weeks according to
response, ma 4.5g/day
✔✔Cholestryamine - ✔✔4g daily or BID (max 24g/day)
✔✔Colestipol - ✔✔-5g daily o rBID initially
- increase by 5g/day increments every 1-2 months according to response max of
30g/day
✔✔Colesevelam - ✔✔3.75g/day given in 1-2 divided doses
✔✔Lipid Panel Monitoring - ✔✔- monitor every 6 weeks initially until LDL target is
achieved
- can extend to every 6-12 months once lipid levels have stabilized
- Lipids, glucose, LFTs, and uric acid are checked 6 weeks after beginning niacin or bile
acid sequestrants
✔✔Advise MD of the Following with Hyperlipidemia - ✔✔- unusual fatigue
- loss of appetite
- upper abdominal pain
- dark colored urine
- yellowing of skin/sclera
✔✔Metabolic Syndrome Conditions - ✔✔1. Type II Diabetes (insulin resistance,
hyperinsulinemia)
2. Abdominal Obesity
3. Hyperlipidemia (reduced HDL, elevated trigs and LDL)
4. Hypertension
✔✔Metabolic Syndrome Causes - ✔✔- genetic predisopositino
- sedentary lifestyle
- overnutrition
- morbid obesity
- high saturated fats and carbs
- steroids
- antidepressants
- antipsychotics
✔✔Metabolic Syndrome Diagnostic Criteria - ✔✔- elevated waist circumference
, - elevated triglycerides >150
- reduced HDL cholesterol <40 for men or <50 for women
- elevated BP (SBP >130, DBP >85 or current treatment for HTN)
- elevated fasting glucose > 100
- may see acanthoses nigricans in neck/axilla
✔✔Metabolic Syndrome Treatment - ✔✔- BP control (ACE, alpha-adrenergic
antagonists)
- Glucose reduction (metformin)
- Targeting LDL cholesterol and non-HDL cholesterol (statins)
- Lifestyle interventions (diet low in saturated fats, physical activity, weightloss)
✔✔Syncope - ✔✔- temporary loss of consciousness and tone followed by spontaneous
recovery, NO resuscitation needed
- often multifactorial
- similar incidence in women and men but increased incidence in women after age 70
✔✔Pre-Syncope - ✔✔sensation of lightheadedness/faintness felt which could lead to
syncope without LOC
✔✔Syncope Cardiac Causes - ✔✔- cardiac valvular disease
- pulmonary HTN
- pulmonary embolism
- pericardial disease
- cardiac tamponade
- MI
- ischemia
✔✔Syncope Arrhythmia Causes - ✔✔- sick sinus syndrome
- AV conduction disturbances
- pacemaker malfunction
- supra-ventricular or v-tach
- prolonged or shortened QT intervals
✔✔Syncope Neurologic Causes - ✔✔- autonomic failure
- vasovagal maneuver (common faint)
- situational (cough, swallow, defacation)
- carotid sinus sensitivity
✔✔Syncope Cerebrovascular Causes - ✔✔TIA
✔✔Syncope Miscellaneous Causes - ✔✔- hypoglycemia
- hypovolemia
- postprandial hypotension
- psychiatric disorders (panic, hysteria, depression)
