Definitions Flashcards
Define hyper lipidemia
Blood disorder characterized by elevations in blood cholesterol levels
What is a major risk factor for coronary heart disease?
Hyper lipidemia
What are the causes of hyper lipidemia?
Genetic, which is primary.
Environmental factors which is secondary.
95% of people have both
Define primary hyper lipidemia
Genetic predisposed
May inherit defective jeans
abnormalities in LDL receptors/mutations in apolipoproteins lead to increase cholesterol production or decrease clearance of it
What are secondary causes of hyperlipidemia (what diseases)
Acute hepatitis, diabetes, hypothyroidism, nephrotic syndrome, primary biliary, cirrhosis, systemic, lupus erythematosus, uremia.
What are secondary causes of hyper lipidemia? (drugs)
Alcohol, beta blockers, glucocorticoids, oral, contraceptives, progestines thiazide diuretics
Define cholesterol
A natural substance produced during sleep by the liver 70% diet 30%
What does cholesterol Help with?
Makes bi asses digestion,
steroid, hormones cholesterol is the precursor of five major classes of steroid hormones
maintains integrity of cell membranes
Found mainly in cells, but 7% circulates in the blood serum
What are the five major classes of steroid hormones?
Glucocorticoids, mineralocorticoids, androgens and estrogens progestagens
Serum cholesterol =
Atherosclerosis
What are the major plasma lipids?
Cholesterol triglycerides phospholipids
Define Lipo proteins
Surround the phospholipids and transport in the blood are produced in the liver and intestines, but endogenous production of Lipo proteins occurs, primarily liver
Apolipoproteins
Specialized proteins on the surface of the lipoprotein.
Identify specific receptors, which lipoprotein will bind
They play a role in development or prevention of hyper lipidemia by controlling interaction in metabolism of Lipo proteins
What are four major Lipo proteins
Chylomicrons, very low density lipoprotein, low density lipoprotein’s, high density lipoprotein
What are chylomicrons
Largest composed, primarily of triglycerides from consumption of fat
What are very low density lipoprotein?
Compose of cholesterol and triglycerides the major carrier of endogenous triglycerides converts to LDL
Low density lipoprotein
Bad cholesterol contains the most cholesterol by way of all the Lipo proteins contain 60 to 75% of total cholesterol
What are high density lipoprotein?
Good cholesterol functions to remove LDL and TG
What is atherosclerosis?
Lesions resulting from accumulation of cholesterol and blood vessels.
It affects large arteries and coronary arteries
How does atherosclerosis develop?
LDL accumulates in the endothelial lining of the intima,
monocytes invade and form macrophages, ingest the LDL and leaves fatty streaks to lesions
Begins in mid teens and lesions grow as people age
Plaque cells grow causing damage to the endothelium this, Lisa platelet aggregation and clot formation
What diseases does atherosclerosis cause?
Coronary heart disease (myocardial infarction significant myocardial, ischemia history of coronary artery bypass graft history of coronary angioplasty angiographic evidence of lesions)
Peripheral vascular disease (claudication)
Carotid, artery disease (Thrombotic stroke transient, ischemic attack)
What are risk factors for hyper lipidemia?
Age, gender systolic blood pressure, antihypertensive therapy, use presence of diabetes and smoking
When should people assess their risk of hyper lipidemia?
Assessment of traditional risk factors in patients age 20 to 39 years without a history of cardiovascular disease every 4-6 years
A full lipid panel, which also contains LDL cholesterol and triglyceride, should be attained fully evaluate a patient’s risk
Patience with a 10 year ASCVD risk greater than or equal to 7.5%.
Are considered a elevated risk for a future ASCVD event
When do guidelines say to start something therapy?
Guidelines, do not recommend starting therapy for patients with a 10 year is less than 5%
Guidelines, do not typically recommend aspirin therapy for patients with attend your wrist less than 10%
If less than 5%, they should start with diet and exercise
What is a coronary artery calcium scan? CAC
It’s a scan that is not invasive procedure that to text after a spootic plaque burden total plaque area ind density
The result of the CAC scan is characterized by the Agatston score
What do you do for a patient who is intermediate risk?
Intermediate risk is greater than or equal to 7.5% or less than 20%.
If risk estimate plus risk enhancers favor, statin initiate moderate intensity statin to reduce LDL by 30% to 49% class one
If risk decision is uncertain, consider a measuring CAC and selected adults
What to do for a patient who is high risk
High risk is greater than or equal to 20%. Initiate starting to reduce LDL by greater than or equal to 50%. Class one
Who does not get a risk assessment immediately goes on statins
LDL equal to or greater than 190 no risk assessment, high intensity, statin
Diabetes and age 40 to 75 moderate intensity statin
Diabetes in age 40 to 75 no risk assessment to consider high intensity statin
Age greater than 75 years old clinical assessment with discussion
What groups do not get placed on statins?
Less than 5% is low risk emphasize lifestyle to reduce risk factors
5% to less than 7.5% is borderline risk. if risk enhancers presents and risk discussion regarding moderate intensity, statin therapy class 11 be
Guidelines on lifestyle management to reduce cardiovascular risk
Diet, high in fruits, vegetables, whole grains, low-fat dairy products, poultry, fish, legumes, nontropical, vegetable oils, and nuts
Exercise aerobic physical exercise, 3 to 4 times a week with each session. Averaging about 40 minutes.
Weight loss
Moderation of alcohol and take
Smoking sensation
What are the goals of statin therapy for high intensity?
LDL reduction of > or equal to 50%
What are the goals for somebody on moderate intensity statin
LDL reduction of less than 30-49%
When is decreasing a statin does not recommend?
For patients who is LDL decreases to less than 40%
How often do you monitor after starting a statin?
Monitor every 3 to 12 months for continued assessment
What are statin side effects?
Muscle related
Pain, tenderness, weakness, fatigue
What do you do if a statin has mild muscle pain
Stop the satin for A week and see if it resolves, then restart at a lower dose
What to do for statin side effects if severe
If severe stop satin and check CKCM creatinine in urine analysis to be evaluated for rhabdo myelosis a severe condition that can cause needs to shut down
Try a different statin for mild
What StATIN does secondary prevention existing clinical ACSVD
Emphasize healthy lifestyle
High intensity, statin use moderate intensity, statin if her intensity is not tolerated
What statin does severe hyper lipidemia get for 20 to 75 years old, LDL greater than or equal to 190
Emphasize healthy lifestyle
Risk assessment not needed
High intensity, statin use moderate intensity, statin if I touch you got tolerated
What Staten does adults with diabetes 40 to 75 years old
Emphasize healthy lifestyle
Risk assessment not required
Moderate intensity, statin, consider high intensity, statin, if multiple respecters exist
What satin does adults for diabetes age 40 to 75 LDL less than 190
Emphasize healthy lifestyle
Risk assessment using race and age, specific PC eat estimate tenure risk
Intermediate risk 7.5-<20 ,gets moderate intensity, statin
High risk greater than or equal to 20% gets high intensity, statin use moderate intensity, statin Pietanza’s not tolerating
