Dyslipidemia Flashcards

1
Q

atherogenesis pathway

A
  • excess LDL gets sequestered underneath the intima of the artery
  • WBC come in
  • differentiate into macrophages (proinflammatory)
  • Swallow up LDL
  • proinflammatory-> releases things to oxidase LDL
  • now oxidized LDL enters blood stream and antibodies are formed against it.
  • Macrophage itself can’t break down cholesterol so macrophages build up. Called foam cells
  • crystallization of the cholesterol inside of the foam cell makes them rupture
  • INFLAMMATION= positive feed back
  • when they all die it forms a calcified plaque
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2
Q

cholesterol vs triglyceride

A

cholesterol is sterile molecule that is a precursor to- steroid hormones, cell membranes, vit. D

triglyceride form adipose tissue

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3
Q

Denovo synthesis

A

decreased cholesterol in diet makes the liver compensate by increasing cholesterol
bc it is accustomed to high levels

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4
Q

2 sources of cholesterol

A

80% liver
20% diet

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5
Q

mevalonate pathway

A

precursor HMGcoa is turned into mevalonate molecule by HMGcoa reductase=Cholesterol after a series of steps
Done in the liver

Statins block HMGcoa reductase

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6
Q

What are the different types of lipoproteins and their function?

A
  • VLDL- turns into LDL
  • LDL-bad; Transporter: excess gets stuck in arteries
  • HDL-good; Scavenger of cholesterol to bring down cholesterol levels.
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7
Q

Calculate the cholesterol risk ratio using the LDL:HDL ratio

A

LDL/HDL

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8
Q

target level of LDL

A

<130

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9
Q

target level of total cholesterol

A

<200

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10
Q

target level of HDL in men

A

> 40

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11
Q

target level of HDL in women

A

> 50

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12
Q

target level of triglycerides is

A

<120

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13
Q

familial hypercholesterolemia is the most common(primary) cause of

A

hyper cholesterol

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14
Q

secondary causes of hypercholesterolemia

A

things that cause increases in cholesterol: diabetes, alcohol etc.

primary is familial

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15
Q

omega 3 fatty acids are good for

A

lowering cholesterol

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16
Q

statin

A
  • # 1 class for dyslipidemia
  • HMGcoa reductase inhibitor
  • put on it d/t high cholesterol and MI
  • statin increase PCSK9

not for pregnant women
baby needs cholesterol and mom needs it to make breast milk

17
Q

Side effects of statin

A

CK elevation
muscle pain/weakness-most common reason why people stop drug

18
Q

Niacin

A
  • AKA Vit. B3
  • prevents VLDL from turning into LDL
19
Q

Niacin side effects

A

cutaneous vasodilation which causes flushing

20
Q

fibrates

A
  • increase breakdown of fat. This decreases VLDL
21
Q

fibrate examples

A

-fib-
gemfibrozil
fenofibrate

22
Q

examples of bile acid bind resin BABR

A

Choles-
Cholestyramine
Cholestipol

23
Q

Absorption inhibitor MOA

A

block NPC1L1 transporter from transporting cholesterol from the bile acid into the body

24
Q

Absorption inhibitor example

A

Ezetimibe

25
Q

side effects of Absorption inhibitor

A

possible atrial wall thickening?

26
Q

MAB- PCSK 9 inhibitors are never given

A

alone, always with a statin
Lowers LDL by 65% if given with statin

27
Q

side effects of MAB- PCSK 9 inhibitor

A

Risk of hypocholesterolemia

28
Q

PCSK9 pathway

A
  • PCSK9 binds to LDL-r. Goes into clatherin coated pit. Receptor is now marked for destruction by the lysosome.

This leads to a decrease in LDL-r

less cholesterol being taken in d/t limited receptors=more in bloodstream

statin increase PCSK9

29
Q

PCSK9 example

A

Evolocumab

30
Q

risks of low cholesterol

A

cancer
hemorrhage stroke

preterm and low birthweight
decrease wound healing