Condition- Dyslipidaemia

Question 1

What is dyslipidaemia?

Answer 1

Elevation of plasma cholesterol, triglycerides or both

Question 2

Lipid travels in blood packaged with proteins as lipoproteins. There are 4 classes- list them

Answer 2

• chylomicrons
• VLDL (mainly TG)
• LDL (mainly cholesterol)
• HDL (mainly phospholipid)

Question 3

List some risk factors for hyperlipidaemia

Answer 3

• FHx
• Insulin resistance + T2DM
• Obesity + fatty diet
• Hypothyroidism
• Cholestatic liver disease
• Certain meds
  
  • High dose thiazides
  • Oral oestrogens
  • GCs
  • Anabolic steroids

Question 4

List some signs of dyslipidaemia on clinical examination

Answer 4

• High BMI
• Xanthoma
  
  • Tendinous (achilles, MCPJ)
  • Tuberous (elbows and knees)
  • Planar (palmar creases)
• Xanthelasma
• Corneal arcus (before 45yrs)

Question 5

List some investigations you should conduct on someone to check for dyslipidaemia?

Answer 5

• BEDSIDE: fundoscopy
• BLOODS:
  
  • Serum lipids: TG, cholesterol, HDL, LDL, ratio
  • Fasting lipids
  • tests for secondray causes: TFTs, HbA1c, liver enzymes

Question 6

How would you manage dyslipidaemia?

Answer 6

CONSERVATIVELY:

• Lose weight 20-25 BMI
• Diet with low fat
• Exercise

MEDICAL:

• 1st line: statins e.g. atorvastatin
• 2nd line: fibrates e.g. ezetimibe
• • PCSK9 inhibitor e.g. alirocumab

Question 7

List some possible complications of dyslipidaemia

Answer 7

• Coronary Artery Disease- IHD +ACS
• Stroke
• PVD
• Can cause pancreatitis