CV Exam (random stuff I need to improve) Flashcards
ranges for desirable, borderline, and high cholesterol?
- Desirable: < 200
- Borderline: 200-240
- High: > 240
NCEP ATP III ranges for optimal/desirable, near/above optimal, borderline high, high, and very high levels of LDL?
- Optimal/desirable: < 100
- Near/above optimal: 100-129
- Borderline high: 130-159
- High: 160-189
- Very high: 190+
List 5 predictive factors used to assess 10-year coronary heart disease risk based on the NCEP’s ATP III guidelines.
Age Diabetes Smoking Blood pressure categories NCEP total cholesterol categories LDL cholesterol categories
Statin effects on % reductions/increases of serum lipids:
v LDL (20-60%), v TG (10-20%), ^ HDL (5-10%)
What is SREBP?
TS factor activated by statin’s action, which increases LDL-receptor expression (binds B100)
Which statins are affected by CYP3A4 inducers/inhibitors?
LSA:
Lovastatin, sivastatin, atorvastatin
Which statins are affected by CYP2C9 inducers/inhibitors?
FR
Fluvastatin, rosuvastatin
Which statin is unaffected by CYP450 metabolism?
Pravastatin
Which statins does gemfibrozil affect, and how?
v OATP2/v Glucoronidation –> ^[all Statins]
Bile acid-binding resins (coles) effects on % reductions/increases of serum lipids:
v LDL (10-25%), small increase in TG
What enzyme is upregulated with use of bile acid-binding resins?
Cholesterol 7alpha-hydroxylase
rate-limiting step of bile acid synthesis
What is NCPL1?
Membrane protein that mediates intestinal cholesterol absorption, inhibited by ezetimibe.
Ezetimibe’s effects on % reductions/increases of serum lipids:
v LDL (~18%)
What is PCSK9?
Protease, produced by the liver, that leads to the degradation of hepatocyte LDL receptors. Inhibited by PCSK9 inhibitors evolocumab, alirocumab.
PCSK9 inhibitors’ effects on % reductions/increases of serum lipids:
v LDL (> 50%)
What is PPAR-alpha? (give detail)
Fibrates are ligands for the PPAR-alpha receptor. Leads to:
A. Decreased ApoC3/increased LPL expression –> increased FA oxidation –> decreased VLDL synthesis –> increased VLDL clearance.
B. Increased apoA1 expression –> increased HDL production.
Fibrates effects on % reductions/increases of serum lipids:
v TG (40-60%), v LDL (10-20%), ^ HDL (10-20%)
How does Niacin act?
A. Decreased lipolysis in adipocytes –> decreased FFA –> decreased VLDL.
B. Inhibits DGAT2 –> decreased VLDL synthesis.
C. ApoCIII –> increased LPL –> increased VLDL clearance.
D. Increased apoAI expression –> increased HDL production.
E. Decreased Lp(a) –> decreased thrombosis.
Niacin’s effects on % reductions/increases of serum lipids:
Effect on serum lipids: v TG (30-80%), v LDL (10-20%), ^ HDL (10-30%)
What are the names of 2 drugs used to treat homozygous FH?
give MoA of each
Lomitapide: Inhibits MTP in both erythrocytes and liver –> decreased production of chylomicrons, VLDL, and LDL
Mipomerson: Antisense oligonucleotide specific for apoB48/100 –> decreased expression of apoB48/100 –> decreased VLDL & LDLs.
What is the major side effect of lomitapide and mipomerson?
Hepatotoxicity.
Optimal triglyceride level?
Very high level?
< 150
> 500
Optimal HDL level in men? Women?
Men: >40
Women: >50
Name the 2 large vessel vasculides and their differentiating factors.
- Temporal/Giant Cell Arteritis: > 50 y/o
2. Takayasu Arteritis: Adults < 50 y/o