2018 Lipidology 2% Flashcards
Type I (Chylomicrons)
Contain TGAs
Defect dec’d familial LPL, CII
Skin lesions: eruptive xanthomas*
Type II (LDL)
Contains: LDL
Defect - dec’d LDL recept
Skin lesions: Tendon xanthomas*
Type III (IDL)
Contains: LDL+TGAs
Defect Abnormal APoE
Skin lesions: Palmar/Tuberous Xanthomas (yellowish looking palm)
Type IV (VLDL)
Contains: TGAs
Defect dec’d familial LPL, CII
Skin Lesions: Eruptive Xanthomas
Type V (VLDL+Chylomicrons)
Contains: TGAs
Defect dec’d familial LPL, CII
Skin Lesions: Eruptive Xanthomas
Statins
Primary LDL tx, decr LDL **, decr. TGA, inc’d HDL
S/E - inc’d LFTs, CPK, wt gain, Glucose intolerance
Fibric Acid derivatives
Primary TGA tx (start when TG > 880)
Inc’d /N LDL, dec’d TGA, inc’d HDL
S/E Gallstone, hepatoma
Bile Acid derivatives
Secondary LDL tx
dec’d LDL, TGAs, inc’d HDL
S/E Bloating, constipation, nausea
Nicotinic Acid
Primary HDL, secondary LDL
dec’d LDL, very dec’d TGA, very inc’d HDL
S/E Abd pain, nausesa, flushing, dry skin
Ezetimibe
TGA tx, seconary LDL
dec’d LDL, dec’d TGA
Apo protien E def
Type III
Def of LDL rct’s
Type IIa
Tendon xanthomas
Type IIa
Pancreatitis
Type I, IV, V
Pt with LDL 140, TGA 600 -0 fhx hypertriglyceridemia
Fibrinc acid derivative (gemfibrozil, fenofibrate)
Which reduces fasting TG of 500 in pt with BMI 30
Losing 5-10% of body weight
Palmar Xanthoma
Most likely defect Apo E
xanthoma treatment
- First line = diet
- monounsaturated fats: olive oil, canola, peanut, sunflower oil,
- Omega 3 and 6 fatty acids
- < 200mg chol
- 15% calories from protein
- fiber 20-30g/day
- exercise
- smoking cessation
What do omega 3 fatty acids do
decrease TG
40yo no risk factors for CAD with LDL 175, wtd next
first diet, therapy, exercise
Pt with DM likely has…
inc’d LDL, inc’d TGA, dec’d HDL
Primary target for therapy in DM pt
LDL
What is initial drug for DM pt with LDL 160, TGA 250, HDL 45
Statin
57yo F with MI, quits smoking, changes diet, started on lipitor 40 LDL 180 to 140, TGA 350 to 250, in about 3 months, HDL 48 wtd?
increase atorvastatin to 80
