Dyslipidemia

Question 1

What is the typical history associated with dyslipidemia?

Answer 1

• Often asymptomatic
• History of cardiovascular risk factors (e.g., family history, obesity, hypertension)
• Possible history of cardiovascular events (e.g., myocardial infarction, stroke)

Question 2

What are the key physical examination findings in dyslipidemia?

Answer 2

• Xanthomas or xanthelasmas (yellowish deposits of fat under the skin)
• Corneal arcus (white or gray ring around the cornea)
• Signs of cardiovascular disease (e.g., carotid bruits, diminished pulses)

Question 3

What investigations are necessary for diagnosing dyslipidemia?

Answer 3

• Lipid profile: total cholesterol, LDL, HDL, triglycerides
• Secondary causes: thyroid function tests, liver function tests, fasting glucose
• Assessment of cardiovascular risk using risk calculators (e.g., ASCVD risk score)

Question 4

What are the non-pharmacological management strategies for dyslipidemia?

Answer 4

• Lifestyle modifications: heart-healthy diet (low in saturated fat, trans fat, and cholesterol)
• Regular physical activity and weight management
• Smoking cessation and limitation of alcohol intake

Question 5

What are the pharmacological management options for dyslipidemia?

Answer 5

• Statins as first-line therapy for LDL reduction
• Ezetimibe or PCSK9 inhibitors for additional LDL lowering
• Fibrates or niacin for triglyceride reduction

Question 6

What are the red flags to look for in dyslipidemia patients?

Answer 6

• Symptoms suggestive of acute cardiovascular events (e.g., chest pain, shortness of breath)
• Extremely high lipid levels (e.g., triglycerides >500 mg/dL)
• New or worsening symptoms of cardiovascular disease

Question 7

When should a patient with dyslipidemia be referred to a specialist?

Answer 7

• Refractory dyslipidemia not responding to lifestyle changes and medications
• Consideration for advanced lipid-lowering therapies (e.g., PCSK9 inhibitors)
• Need for specialized lipid management or evaluation of secondary causes

Question 8

What is one key piece of pathophysiology related to dyslipidemia?

Answer 8

• Abnormal levels of lipids in the blood (e.g., high LDL, low HDL, high triglycerides)
• Contributes to the development of atherosclerosis
• Increases the risk of cardiovascular events such as myocardial infarction and stroke