Clinical Guidelines of HLD

Question 1

what is primary prevention?

Answer 1

patients with no previous ASCVD events

Question 2

what is secondary prevention?

Answer 2

patients with previous ASCVD events
- MI
- stable/unstable angina
- revascularization, stroke
- TIA
- PAD
- aortic aneurysm

Question 3

Start Statin right away if:
- clinical ___ at any age
- primary hypercholesterolemia a LDL-C greater than or equal to ___ mg/dL
- patients aged ___ - ___ yo with ___
- ___ hypercholesterolemia

Answer 3

ASCVD
190
45-70, DM
familial

Question 4

follow up and monitoring recommendations

1) initiate statin
2) follow up in ___ - ___ until dose stable
3) follow up every ___ - ___ months

Answer 4

4-12
3-12

Question 5

Coronary Artery Calcum (CAC) Test

• ___ of the chest to measue __ buildup
• use rarley if risk decision is uncertain to determine initiation of statin

CAC = 0 - assess other risk factors to determine need
CAC = 1-99 - favors statin therapy, especially age ___ +
CAC greater than or equal to 100 - initiate at least ___ -intesnsity statin

Answer 5

• CT, Ca2+
• 55+
• moderate

Question 6

for primary prevention, we want an LDL less than ___

Answer 6

100

Question 7

for secondary prevention, we want an LDL less than ___

Answer 7

70

Question 8

non-statin recommendations (after max tolerated statin)

1st line: ___ - use if LDL not at goal according to condition, or if patients with ___ have an ASCVD risk of greater than ___ %

2nd line: ___ inhibitors - can consider if ___ and/or ___ still not at goal. Considered if patients cannot tolerate ___ or ___

3rd line: ___ - if less than ___ % reduction in ___ on max tolerated statin + ___ and have TG greater than ___ mg/dL

Answer 8

• ezetimibe, DM, 20%
• LDL, non-HDL, statin, ezetimibe
• BAS, 50, LDL-C, ezetimibe, 300

Question 9

categories of hypertriglyceridemia

persistent: fasting TG > ___ mg/dL following 4-12 weeks of LSM, max statins, and 2nd cause evaluation

moderate ( ___ - ___ mg/dL): excess TGs carried in ___

severe ( > ____ mg/dL): excess TGs are carries in ___ and ___. Chylomicrons can cause acute ___

Answer 9

• 150
• 150-499, VLDL
• 500, VLDL, chylomicrons, pancreatitis

Question 10

Pharmacologic treatment of TG

moderate: start ___
severe: start ___
other therapies in severe: ___ + ___ or ___

Answer 10

statin
statin
statin, fibratem omerga-3 fatty acids

Question 11

T or F: although statins are known to reduce TGs, they alone cannot prevent acute pancreatitis in the setting of secondary causes

Answer 11

True

Question 12

T or F: fibrates of omega-3 fatty acis are the go to PCOL to decrease the risk of acute pancreatitis

Answer 12

True

Question 13

Five finger method

1) primary or secondary?
2) LDL over 190?
3) DM?
4) ASCVD over 20%?

Answer 13