Dyslipidemia Flashcards
Pancaritits happen in increase in ?
Triglyceride >1500
Beat way to reduce Hypertryglecrudemia ?
Lowering SUGAR + ALCHOL
Reducing Tri will increase your ?
HDL
Secondary prevention of ASCVD?
Patient have clinical ASCVD ?
Give statin ? High or moderate?
1- give high intensity statin if very high risk ( >2 event OR 1 event + >2 conditions) and target LDL 70mg/dl
* add on therapy : Ezatimibe, PCSK9 inh*
2- not very high risk ?
Look at age
>75? Give moderate statin
< less than 75 give high intensity statin
In clinical ASCVD patient what is considered very high risk? 
Very high risk ( 2 major event \ OR. 1 event + 2> conditions
Major events :
- MI hx
- ischemic stroke
- recent ACS
- symptomatic PAD.
High risk conditions
- CKD
- CHF
- hx of CABG / PCI
- age >65
- SMOKER 💨
- LDL>100 despite max dose of statin
Primary prevention of ASCVD in patient with LDL>190 ? 
We use HIGH intensity statins *⛓ with a 🎯 goal of 💯 ? Give PCSK9
3- LDL>100 and {fasting TG < 300} : give BAS inhibitors
Primary prevention of ASCVD in diabetic patients? 
NEED to do the (ASCVD risk 10 y calculator)
Then
1- >20% ( 10 years risk )
( give high intensity statin)
2- <20% (10 y risk)
(Give moderate intensity statin)
DM specific risk enhancer? 
1- long duration of
Albuminurea >30
2- eGFR<60
3- retinopathy
4- neuropathy
Medication cause hyperlipidaemia?
- diuretics
- steroids
- amiodarone
Medication causing hypertriglyceridaemia
- Retinoids
- OCP
- thiazides
- tamoxifen
- Beta-blockers
Mx of hypertryglycremia ?
MAINLY ( diet ) dependent
Controversy on 💊 ?
- omega 3 , fibrates , statins
What medication have a ASCVD risk reduction ?
Statins
What medication have the highest reduction in the LDL 50-75% ???
PCSK9 inhibitors
Side effects of statins?
- Myalgia
- rhabdomyolysis ( check CK )
- hepatotoxicity ( ALT,AST) 
Hypertension
Normal :<120\<80 Elevated 120-129 \<80 Hypertension Stage1 : 130-139/80-89 Stage 2 : 140/90
Isolated systolic hypertension
_> 130 /<80
Isolated diastolic hypertension
<130 / _>80
Screening for HT
Screening all individual 18 and older
Screening adult HT
In normal adult screening is annually
When to do semiannually screen for HT?
1-For adult with prev elevated BP
: 120-129 s
2- adult with risk factor like obesity ⚠️
🎯 goal BP for most ppl ?
<130 /<80 mmHg
Less aggressive 🎯 goal <140 /<90 to whom ?
- age 75 or older
- diastolic pressure <55
- patient with labile BP or postural hypotension ⚠️
- pt have side effects if multiple medication
- patient of 💊 three medication ( including diuretics)
Medication 💊 causes hypertension?
- OCP
- NSAIDs
- Decongestant( phenylephedrine - pseudoephedrine )
🧪 laboratory test for (ALL) new Dx HTN ?
- electrolytes ( include ca+ ) + creatinine for GFR
- urinalysis ( check ⚠️ microalbuminura )
- CBC
- TSH
- Fasting glucose 🍩
- echocardiogram
- calculate ASCVD
- lipid profile 🧫
Thin , labile blood pressures ups and downs , diaphoresis(sweat) , tachycardia?
Think pheochrmosytoma
Diet for HTN?
DASH
Mx for HTN
- thiazide diuretic
- ACE /ARBs
- Ca+ blockers ( amlodipine )
1st line for diabetics + hypertensive?
ACE Inhibitors 💊
Bc it reduces Proteinuria ⚠️
ACE contraindications?
Angioedema
Contraindications HTN med in pregnancy
ACE , ARBs , renin inhibitors
Used in HTN. Pregnant
Methylodopa
When to use B blocker in hypertension?
If there is 🔽 reduced ejection fraction
In ♥️ failure
If comirbid : migraine, BPH , essential tremor
Don’t ❌ use B blocker for ischemic heart disease
