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Endocrine > 1: Hyperlipidaemia > Flashcards

1: Hyperlipidaemia Flashcards

1
Q

How do lipids travel in the blood

A

Bound to lipoproteins

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2
Q

What are the four types of lipid and lipoprotein

A
  • Chylomicrons
  • VLDL
  • LDL
  • HDL
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3
Q

What are VLDLs

A

Triglycerides

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4
Q

What are LDLs

A

Cholesterol

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5
Q

What are HDLs

A

Phospholipids

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6
Q

What are the two types of hyperlipidaemia

A

Primary hyperlipidaemia

Secondary hyperlipidaemia

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7
Q

What are the two types of primary hyperlipidaemias

A
  1. Common primary hyperlipidaemia
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8
Q

What % of primary hyperlipidaemia are common primary hyperlipidaemia

A

70%

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9
Q

What is raised in common primary hyperlipidaemia

A

LDL (Cholesterol)

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10
Q

What is secondary hyperlipidaemia

A

Raised LDL due to another underlying disease process

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11
Q

How does secondary hyperlipidaemia present

A

Raised LDL (Cholesterol)

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12
Q

give 4 causes of secondary hyperlipidaemia

A
  • Cushing’s disease
  • DM
  • Hypothyroidism
  • Nephrotic syndrome
  • Cholestasis
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13
Q

what is a mixed hyperlipidaemia

A

Raised LDL (Cholesterol) and VLDL (TGs)

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14
Q

what is another method to classify hyperlipidaemia

A

Congenital and Acquired

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15
Q

who classified familial hyperlipidaemias

A

Freidrickson

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16
Q

what is type I

A

Familial Hyperchylomicronaemia

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17
Q

what is the inheritance pattern of familial hyperchylomicronaemia

A

Autosomal Recessive

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18
Q

what causes familial hyperchylomicronaemia

A

Apo C deficiency

Lipoproteinlipase deficiency

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19
Q

how does familial hyperchylomicronaemia present clinically

A
  • Recurrent acute pancreatitis
  • Eruptive xanthomas
  • Hepatosplenomegaly
  • Lipemia retinalis
  • Bile duct stenosis
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20
Q

what is the main feature of familial hyperchylomicronaemia

A

Recurrent acute pancreatitis

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21
Q

what defect is present in familial hyperchylomicronaemia

A
  • High chylomicrons

- High VLDLs (triglycerides)

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22
Q

how prevalent is familial hyperchylomicronaemia

A

rare

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23
Q

what is type IIa

A

Familial hypercholesterolaemia

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24
Q

what % of familial hyperlipidaemias are familial hypercholesterolaemia

A

10

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25
what is the inheritance pattern of familial hypercholesterolaemia
Autosomal Dominant
26
what cause familial hypercholesterolaemia
LDL Deficiency
27
what are the 4 symptoms of familial hypercholesterolaemia
- Xanthelasma - Tendon Xanthoma - Corneal Arcus - Premature atherosclerosis
28
what causes tendon xanthomas
Familial Hypercholesterolaemia
29
what deficit is present in familial hypercholesterolaemia
High LDL (Cholesterol)
30
what is type IIb familial hyperlipidaemia
Familial Combined Hyperlipidaemia
31
what % of individuals have type IIb
10%
32
what is the inheritance pattern of familial combined hyperlipidaemia
Autosomal Dominant
33
what is the cause of familial combined hyperlipidaemia
ApoB100 deficiency
34
how does familial combined hyperlipidaemia present
Corneal Arcus | Xanthelasma
35
what is the abnormalities in lipids in familial combined hyperlipidaemia
High LDL | High VLDL
36
what is type III familial hyperlipidaemia
familial dysbetalipoproteinaemia
37
what is the inheritance pattern of dysbetalipoproteiaemia
autosomal recessive
38
what % of individuals have dysbetalipoproteinaemia
5
39
what causes dysbetalipoproteinaemia
Autosomal Recessive
40
what defect is present dysbetalipoproteinaemia
ApoE deficiency
41
what are 3 symptoms of dysbetalipoproteinaemia
Palmar striae Pre-mature atherosclerosis Tubero-eruptive xanthoma
42
what defect is present in dysbetalipoproteinaemia
``` Increase VLDL (triglycerides) Increase chylomicrons ```
43
what is the most common familial hyperlipidaemia disorder
Familial hypertriglyceridaemia (70%)
44
what is the inheritance pattern of familial hyper triglycerdiaemia
AD
45
what causes familial hypertriglyceridaemia
Overproduction of VLDL by the liver
46
what are symptoms of familial hypertriglyceridaemia
- Premature atherosclerosis - Eruptive xanthoma - Lidipaemia retinalis - Hepatosplenomegaly
47
what defect is present in familial hypertriglyceridaemia
Raised LDL
48
how should individuals at risk of hyperlipidaemia be screened
Fasting Lipid Profile
49
what are the two 'at-risk' categories
- Those at risk of hyperlipidaemia | - Those at risk of CVD
50
what are 3 indicators of 'at risk' of hyperlipidaemia
- FH - Corneal Marcus before 40-years - Xanthomata
51
what is an eruptive xanthoma
Itchy yellow nodules
52
what is an tuberous xanthoma
Yellow nodules on knees or elbows
53
who are individuals at risk of CVD
- FH - Known CVD - Diabetes - IGT - HTN - Smoking - High BMI
54
explain gender changes in cholesterol
Males have higher cholesterol until menopause - then females
55
how do patients with high lipids usually present
Asymptomatic. May have xanthomas
56
which lipid has greatest risk for coronary artery disease
LDL
57
how is LDL measured
LDL = Total serum cholesterol - HDL - TG/5
58
what is the effect of HDL
protective: transports LDL from tissues to the liver
59
explain cholesterol (LDL) to HDL ratio
Lower LDL:HDL - the lower risk of CAD. A ratio of 10 doubles CAD
60
what is first line investigation in hyperlipidaemia
Lipid screen
61
if lipid screen is abnormal, what is ordered
If LDL or HDL abnormal on lipid screen order fasting lipid profile
62
when is fasting lipid profile the first-investigation
- FH Hyperlipidaemia - Corneal arcus under 50-years - Xanthoma - FH CVD under 60 - CVD - Smoker - Higher BMI - HTN
63
what is first-line management of hyperlipidaemia
Statin
64
what dose of atorvastatin is given for primary prevention
20mg
65
what are indications for primary prevention
T1DM GFR <60 QRISK2 >10%
66
what dose is given for secondary prevention
80mg
67
what are indications for secondary prevention
CVD, CAD, PAD
68
what is aim when individual is put on statin
non-HDL reduction by 40%
69
what is second line for high lipids
Ezetimibe
70
what is ezetimibe
Prevents absorption of cholesterol
71
when is ezetimibe used
Statins not tolerated or 40% reduction in HDL cannot be achieved
72
how much does familial hypercholesterolaemia (IIa) increase risk of CAD
40-times. | 50% will have MI by 60-years if untreated

Endocrine (20 decks)

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