Dyslipidaemia

Question 1

Define Dyslipidaemia

Answer 1

Elevation of total cholesterol and /or low-density lipoprotein cholesterol or non-high-density lipoprotein cholesterol in the blood

Question 2

Aetiology of Dyslipidaemia

Answer 2

Primary: single or multiple gene mutations

Secondary (raised LDL): Sedentary lifestyles consumption of saturated fats, Cushing’s, Hypothyroidism, nephrotic syndrome, cholestasis

Mixed: T2DM, Metabolic syndrome, alcohol abuse, chronic renal failure

Question 3

Epidemiology of Dyslipidaemia

Answer 3

1/2 of the UK population have serum cholesterol putting them at significant risk of CVD
70% of cases are primary
3x higher rate in developing countries than developed

Question 4

Symptoms of Dyslipidaemia

Answer 4

Presents with the long-standing dyslipidaemia complications

Chest pain
SOB 
Weakness
Dysphasia 
Claudication

Question 5

Signs of Dyslipidaemia

Answer 5

Excess body weight
Xanthelasma 
Tendinous xanthoma 
Arcus cornealis 
Tuberous xanthomas

Question 6

Investigations for Dyslipidaemia

Answer 6

Lipid profile: TC >5.18 and LDL > 2.59

Lipoprotein (a) values >50 mg/dL

Investigate for causes.g. TFTs

Question 7

Management for Dyslipidaemia

Answer 7

Lifestyle advice:
Aim BMI 20-25
Mediterranean-style diet (fruit, vegetables, fish, unsaturated fats)
Increase exercise

Medical:

1. Atorvastatin 20mg PO at night
2. Exetimibe (statin intolerance or in combo)
3. Alirocumab/evolocumab (monoclonal against PCSK9)

Question 8

Complications of Dyslipidaemia

Answer 8

Ischaemic heart disease
Peripheral vascular disease
Acute coronary syndrome
Stroke
Erectile dysfunction

Question 9

Prognosis of Dyslipidaemia

Answer 9

Overall prognosis improved if there is detection and management of all factors that contribute to CHD
Cholesterol reduction is useful as a CHD-risk reduction strategy