Lipid Biochemistry USMLE Step 1 Practice Question
A 62-year-old man with a history of myocardial infarction is started on a statin for secondary prevention. After 4 weeks of therapy, his LDL decreases by 35%, but he develops myalgias and elevated creatine kinase (2000 IU/L). Which of the following represents the mechanism by which statins caused this adverse effect?
Answer choices
- AIncreased acetyl-CoA carboxylase activity leading to fatty acid accumulation
- BIncreased production of oxygen-free radicals in skeletal muscle
- CDirect inhibition of muscle lipoprotein lipase
- DReduced CoQ10 synthesis impairing muscle glucose metabolism
- EDepletion of mevalonate pathway intermediates required for muscle mitochondrial functionCorrect answer
- FSarcolemmal cholesterol depletion from direct myocyte HMG-CoA reductase inhibition
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