Dyslipidaemia

Question 1

What is dyslipidemia?

Answer 1

The elevation of Cholesterol, Triglycerides or both; or the lowering of HDL, which contributes to atherosclerosis

Question 2

What are apoproteins function?

Answer 2

Stabilization of lipoproteins
Regulator of lipoprotein metabolism
Secretion of lipoproteins
Carry protective effect to prevent atherosclerosis

Question 3

What mainly causes high LDL plasma levels?

Answer 3

Low LDL receptor activity or receptor defects

Question 4

HDL’s two fold protective effect

Answer 4

Reverse cholesterol transport

Anti oxidative activity

Question 5

Altered TG levels increase risk of?

Answer 5

Pancreatitis

Retinal vein thrombosis

Question 6

What drugs can cause dyslipidaemia?

Answer 6

Steroid hormones
Retinoic acids
HAART

Question 7

Lipoprotein status of Primary isolated hypertriglyceridemia

Answer 7

High VLDL output by liver
High ratio of TG to ApoB
HDL & LDL levels are low.
Recurrent abdominal pain and pancreatitis

Question 8

What is the treatment of Primary isolated hypertriglyceridemia and what is it aimed at?

Answer 8

Fibrates, Fish oils & Nicotinic Acid

Treatment aimed at reducing risk pancreatitis

Question 9

What is the treatment of Familial hypercholesterolemia?

Answer 9

Aggressive lipid lowering

Question 10

Typical features of metabolic syndrome

Answer 10

Abdominal obesity
Hypertension
Abnormal lipid profile
High glucose levels

Question 11

Lipid profile of metabolic syndrome

Answer 11

High TG
Low HDL
High Apo B

Question 12

Statins are used in what level of prevention?

Answer 12

Secondary

Question 13

Who needs secondary prevention?

Answer 13

DM 1 with target organ damage
DM 2
Familial hypercholesterolemia
Chronic kidney disease
Established CVD

Question 14

WHen would you need an immediate drug intervention?

Answer 14

High risk >2.5 LDL

Very high risk >1.8 LDL

Question 15

What lipid lowering drug is used for predominant hypercholesterolaemia?

Answer 15

Statin

Bile acid sequestrants

Question 16

In primary dyslipidaemia, what does lipid lowering treatment try to achieve?

Answer 16

LDL-C 50% reduction

Question 17

What dietry factors promote CVD?

Answer 17

Saturated fatty acids
Trans fatty acids
Total cholesterol (LDL)
High sodium intake
Excessive alcohol intake

Question 18

Mechanisms of omega 3

Answer 18

Decrease arrhythmias
Antithrombotic
Decrease T-chol and TG
Inhibit atherosclerotic inflammation

Question 19

Increase HDL

Answer 19

Exercise
Healthy diet
Stop smoking
Moderate alcohol intake

Question 20

Risks of treatment

Answer 20

Muscle damage
Liver damage
Cost

Question 21

Who should be treated?

Answer 21

Secondary prevention candidates

Question 22

When is the Framingham algorithm used?

Answer 22

In primary prevention

Question 23

What treatment strategy is used in primary prevention?

Answer 23

Treat cause of dyslipidaemia
Lifestyle modification
Modify other risk factors

Question 24

What drug Rx is used for predominant hypertriglyceridaemia?

Answer 24

Fibrate therapy
Nicotinic acid (not tolerated well)

Question 25

What statin is low risk and cost and has a long half-life?

Answer 25

Atorvastatin

Question 26

When are statin usually given and why?

Answer 26

At night as this is when cholesterol synthesis peaks

Question 27

AE of fibrates

Answer 27

GIT symptoms
Raised liver enzymes
Myopathy

Question 28

What is the function of Ezetimibe?

Answer 28

Cholesterol absorption inhibitor

Question 29

AE of nicotinic acid?

Answer 29

Intense cutaneous flushing (take aspirin before)
Loss of glycaemic control
High pill burden