Dyslipidaemias Flashcards
What is the healthy level for non-HDL cholesterol?
4 mmol/L or below.
What is the minimum HDL cholesterol level for men?
1 mmol/L or above.
What is the healthy LDL cholesterol level?
3 mmol/L or below.
What is the maximum total cholesterol level for healthy individuals?
5 mmol/L or below.
What should the total cholesterol to HDL ratio be for a healthy individual?
6 or below.
What is the healthy level for fasting triglycerides?
1.7 mmol/L or below.
What is the healthy level for non-fasting triglycerides?
2.3 mmol/L or below.
What are some complications associated with hypercholesterolaemia?
Ischaemic heart disease, Peripheral vascular disease, Acute coronary syndrome, Erectile dysfunction.
What health risks are associated with high triglycerides?
Heart disease, Pancreatitis, Metabolic syndrome, Fatty liver disease.
What is the first-line treatment for high cholesterol and triglycerides?
Statins.
What should be monitored before starting lipid-modification treatment?
Creatine Kinase (CK), Liver Function Tests, Renal Function, HbA1c, Thyroid Stimulating Hormone.
What is Familial Hypercholesterolaemia (FH)?
An inherited condition leading to high cholesterol, early atherosclerosis, and heart disease.
What are the diagnostic criteria for FH in adults?
Total cholesterol > 7.5 mmol/L or LDL cholesterol > 4.9 mmol/L, and/or a family history of premature coronary heart disease (before 60).
What are common clinical signs of FH?
Tendon xanthomas (yellowish lumps on tendons) and Arcus cornealis (greyish-white ring around the cornea).
What is the goal for LDL cholesterol reduction in FH treatment?
A reduction of more than 50%.
What is the first-line treatment for Familial Hypercholesterolaemia (FH)?
High-intensity statin therapy.
What are the main treatment options for Homozygous FH?
Statins, bile acid sequestrants, fibrates, nicotinic acid, LDL apheresis, and possibly liver transplant in severe cases.
What is the role of genetic testing in FH?
It confirms FH by identifying mutations in the LDL receptor gene or other genetic markers.
How often should lipid monitoring be done for patients on lipid-modification treatment?
Every 2-3 months after starting treatment and annually thereafter.
What should be done if statins fail to lower LDL cholesterol effectively in FH patients?
Add ezetimibe 10mg OD or switch to an alternative statin.
What is the main complication of untreated Familial Hypercholesterolaemia (FH)?
Early-onset atherosclerosis and heart disease.
What is the treatment for severe Familial Hypercholesterolaemia when dual therapy fails?
Referral to a specialist for possible treatments like fibrates, bile acid sequestrants, or PCSK9 inhibitors.
What does “cascade testing” involve in the context of FH?
Testing family members (first-degree relatives) of a person diagnosed with FH to identify others who may also be affected.
What is the recommended treatment for patients with FH who are intolerant to statins?
Ezetimibe 10mg once daily, or a referral to a specialist for further treatment.
What are the contraindications for using high-dose Simvastatin (80mg)?
The benefits should outweigh the risks, especially in severe hypercholesterolaemia, and it should be used with caution in patients at risk for muscle-related side effects.
What are some common side effects associated with statins?
Muscle pain (myopathy), liver enzyme changes, and digestive issues.
What is the role of omega-3 fatty acid supplements in FH management?
They are not routinely recommended for FH patients.
What is the relationship between hypothyroidism and dyslipidaemia?
Untreated hypothyroidism can increase the risk of dyslipidaemia, contributing to higher cholesterol levels.
When should liver function tests be performed during lipid-modification treatment?
2-3 months after starting treatment and then annually thereafter.
What is the maximum dose of Simvastatin considered safe for most patients?
40mg, unless higher doses are specifically indicated by a specialist.
What is the role of fibrates in the management of hypercholesterolaemia?
Fibrates are more effective for lowering triglycerides than statins.
What should be done if a patient with FH does not achieve LDL cholesterol reduction with statins?
Consider adding ezetimibe, switching to a different statin, or using PCSK9 inhibitors.
What test should be conducted before starting lipid-modification therapy in patients at high risk of muscle-related side effects?
Creatine Kinase (CK) test to assess muscle pain risk.
What is creatine kinase (CK)?
An enzyme primarily found in the heart, brain, and skeletal muscles, released into the bloodstream when these tissues are damaged, serving as a biomarker for muscle damage.
