Dyslipidemia

Question 1

Cholesterol biosynthesis: Where is it manufactured? What is it made from? When does it occur?

Answer 1

• Liver
• Made from Acetyl CoA
• Occurs at night
• Rate limiting step: HMG-CoA reductase

Question 2

Dyslipidemia can lead to what?

Answer 2

• Acute pancreatitis

- Atherosclerosis –> CHD

Question 3

What are the risk factors for dyslipidemia?

Answer 3

“FLASH”

• Family hx of CHD
• Low HDL
• Age
• Smoking
• HTN
• (& CKD)

Question 4

What is the risk equivalent to CHD?

Answer 4

• DM
• CAD
• PAD
• AAA

Question 5

What are dosing recommendations according to AHA/ACC guidelines?

Answer 5

• No evidence to support titrating to achieve target LDL or HDL
• Appropriate intensity (moderate & high) of statin therapy should be used to reduce ASCVD in those most likely to benefit

Question 6

Who is likely to benefit from statin therapy?

Answer 6

Those w/:

• ASCVD
• Elevated LDL
• DM aged 40-75 w/ LDL 70-189 & w/out evidence of ASCVD
• LDL 70-189 & estimated 10 yr risk of ASCVD ≥ 7.5%

*USPSTF recommends using low-moderate intensity in pts w/ combo of at least 1 ASCVD RF & a 10 yr risk of ASCVD ≥ 10%

Question 7

1% reduction in LDL, results in what?

Answer 7

1% reduction in CHD

Question 8

1% elevation of HDL, results in what?

Answer 8

2% reduction in CHD

Question 9

What does TLC do?

Answer 9

Assists in lowering LDL & reducing CHD risk

Question 10

What are examples of TLC?

Answer 10

• Reduce intake of saturated fats & cholesterol
• Increase stanol/sterol & fiber intake
• Weight loss
• Increase activity