Discussion of Cholesterol lipoproteins Flashcards
What are the guidelines for needing to be treated with statins?
known heart disease or diabetes
LDL cholesterol >= 190mg/dL
if you’re talking statins, there’s no need to monitor LDL levels or take non-statin drugs
What are the guidelines for needing to be treated with statins?
known heart disease or diabetes
LDL cholesterol >= 190mg/dL
if you’re talking statins, there’s no need to monitor LDL levels or take non-statin drugs
What are some clinical manifestation of familial hypercholesterolemia?
corneal arcus, thickened achiles tendons, high total cholesterol, normal TAG and HDL, very high LDL
What is optimal LDL levels
What are the main causes of hypercholesterolemia?
LDL receptor defects, defects in ApoB, gain function mutation of PCSK9
inability to clear plasma LDL
What is the prevalence of heterozygous hyperchoelsteremia?
1: 500 (autosomal dominant)
- premature atherosclerosis
What is the prevalence of homozygous hyperchoelsteremia?
1:1000000
cardiac disease in childhood
What is the treatment of FH?
diet, exercise (not all that effect because its a genetic problem), reduce total fat and cholesterol intake, statin drugs, Ezetimibe (NPC1L1 inhibitor) in combo with statins,
What are some new therapies for homozygous FH patients?
lomitapide- MTP inhibitor
Mipomersen- apoB inhibiting
synthetic HDL injections
possible liver transplant- liver has the most LDL receptors but this is extreme
What would a mutation in the large subunit of MTP (abetalipoproteinemia) show as clinically?
very low total cholesterol, HDL, LDL, TAG, undetectable apoB, acanthocytes (pointy red cells), lipids in enterocytes after fasting, eye problems
heterozygotes are normal, homozygotes are not- thus, autosomal recessive
due to vitamin E deficiency
Treatment for Abetalipoproteinemia?
huge doses of vitamin E (absorbed with chylomicrons, so if you can’t make chylomicrons, you can’t make vitamin E) to reverse neurologic and optic problems and supplements of fatty acids.
What are the symptoms of Metabolic syndrome?
hypertensive, abdominal obesity, extremely high TAG, elevated total cholesterol, slightly elevated LDL, elevated ApoB (higher than LDL), and low HDL
Why is abdominal obesity worse than hip
most of the fat in the abdomen is visceral adipose tissue which is more metabolically active which makes cytokines that dump into the liver while hip fat is subcutaneous
What are some clinical manifestation of familial hypercholesterolemia?
corneal arcus, thickened achiles tendons, high total cholesterol, normal TAG and HDL, very high LDL
What is optimal LDL levels
