Dyslipidemia Flashcards

9, 10, 11, 34, 35, 49

1
Q

What are drugs that increase LDL and decrease HDL as a side effect?

A

progestins, steroids, corticosteroids

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2
Q

What are causes of secondary dyslipidemia?

A

DM, hypothyroidism, liver disease, renal failure, drugs

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3
Q

Diabetes is considered what kind of a risk factor?

A

CHD-Eqiuvalent, LDL goal of <100

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4
Q

What is your 10-year risk if you have 2 risk factors? 1?

A

20%, 10%

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5
Q

How often should a fasting lipid profile be performed in adults >20?

A

every 5 years

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6
Q

If a patient is non fasting for their lipid panel, which values are still accurate?

A

total cholesterol and HDL

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7
Q

What are the optimal cholesterol values?

A

total cholesterol 40, TG < 150

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8
Q

What is the LDL goal of a patient with 2+ risk factors?

A

<130

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9
Q

What are dietary TLC changes we can recommend to our patients?

A

Reduce saturated fat and cholesterol, consider adding plant stanols/sterols, increase viscous fiber intake

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10
Q

Let’s say you began a patient on TLC and saw them 6 weeks later in follow-up and they are still not at goal LDL. Do you start LDL-lowering therapy?

A

No. Reinforce dietary suggestions and consider referral to dietician. Drugs should not be initiated until 3rd visit if still not at goal LDL.

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11
Q

Patients with familial hypercholesteremia usually require combination therapy with which 2 drug types?

A

statin + bile-sequestering agent

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12
Q

Ideal triglycerides are <150. If a patient has TG of 150-200 what is the aim of therapy? If they are 200-499? over 500?

A

Try to achieve LDL goal first. Consider addition of fibrate or niacin. If over 500 want to prevent pancreatitis!

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13
Q

What is the primary target of therapy in patients with low HDLs?

A

LDLs. Once LDL is reached, then goal is weight reduction and increasing physical activity. FIbrates and niacin can help.

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14
Q

What are our concerns with a patient with familial hyperchylomicronemia?

A

Worry about them not getting their fat soluble vitamins, also can get severe pancreatitis. may require plasmaphoresis.

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15
Q

What are the MAJOR risk factors for atherosclerosis/CHD that count as risk factors in the framingham score?

A

smoking, HTN (or on anti-HTN med), HDL< 40, age (men>40, women >55)

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16
Q

What drug has the most LDL lowering effect?

A

statins

17
Q

Which drug has the most HDL raising effect?

A

Niacin

18
Q

Which drug has the most TG lowering effect?

A

FIbrates

19
Q

What are common adverse effects of niacin?

A

flushing, gout (contraindicated if already have gout), hyperglycemia

20
Q

What are adverse effects of statins?

A

myopathy, increased liver enzymes

21
Q

Which drugs are contraindicated in patients with chronic liver disease?

A

Statins, niacin, fibrates

22
Q

which drugs are BSAs?

A

cholestyramine, colestipol

23
Q

Which drugs are HMG co-A reductase inhibitors?

A

statins

24
Q

Which drugs are fibric acid derivatives?

A

gemfibrozil, clofibrate, fenofibrate

25
Q

What are other life habit risk factors that can increase your CHD risk? (not counted in 10-year risk)

A

obesity (BMI >30), diet high in cholesterol, physical inactivity, African American

26
Q

What lab tests should be performed to rule out secondary causes of lipid disorders?

A

fasting blood glucose (DM), thyroid-stimulating hormone (hypothyroidism), serum creatinine (renal function), UA for proteinuria (kidneys), alkaline phosphatase (liver)