Dyslipidemia Flashcards
Familial hypercholesterolemia
Rare- up to 8x normal LDL levels
- absent/ defective surface cell receptors for LDL molecule-> unregulated synthesis of LDL.
- May require liver transplant.
Familial hyperchylomironemia
- Rare- abnormality of lipoprotein lipase
- Marked hypertriglyceremia, pancreatitis and hepatosplenomegaly
Hypercholesterolemia
High total cholesterol- can be due to increased LDL, HDL or triglycerides-
High LDL = increased risk of heart disease
Elevated LDL- Sx/ Dx
- tendinous xanthomas
- LDL >130 (+risk factors) - 160
- increased risk of atherosclerotic heart disease
Elevated LDL- Tx
- Low fat, plant based diet
- Increased exercise
- Reduce alcohol
- Meds: statins, niacin
Secondary causes of elevated Total Cholesterol
DM, hypothyroid, nephrotic syndrome, CKD, obstructive liver disease, cushing, contraceptives, diuretics, beta-blockers
Secondary causes of decreased TC
Hyperthyroid, cirrhosis, malignancy
Hypertriglyceremia- Dx/ Sx
> 150 mg/dL
- lipidemia retinalis
- Increased risk of pancreatitis
Hypertriglyceremia- Tx
- Dietary- avoid alcohol, sugar, starch, trans-fats,
- Med: Niacin, fibric acid
ACC/ AHA Guidelines
- Replacement to ATP III
- Asses risk 21-79 free from CVD (heart / end stage renal disease) every 4-6 years
- Routine monitoring on statins eliminated
ACC/ AHA 10 CVD Risk factors
Sex, age, race, TC, HDL, Systolic BP, HTN, DM, Smoker
ACC/ AHA:
-DM + 40-75 + LDL 70-189
Risk 7.5% high intensity statins
ACC/ AHA:
- No DM + 40-75 + LDL 70-189
Risk > 7.5% moderate to high intensity statins
ACC/ AHA:
LDL > 190
High intensity statins
NCEP Guidelines
- 20+ fasting lipoprotein profile Q 5 yrs
- Calculate 10 yr risk of CHD
- RO familial causes of HLD
