Dyslipidemia And Hyperlipidemia

Question 1

Is defined as an elevated total or low density ( LDL) cholesterol levels or low levels of HDL cholesterol

It’s an important risk factor for coronary heart disease and stroke

Answer 1

Dyslipidemia

Question 2

Referral to an abnormally high concentration of fats or lipids in the blood and interchangeable with Dyslipidemia

Answer 2

Hyperlipidemia

Question 3

Is a major component of all cell membranes

Used to make essential molecules such as hormones, fat-soluble vitamins, and bile acids to digest food

Answer 3

Cholesterol

Question 4

Are stored in fat cells

Are released by hormones for energy between meals

Answer 4

Triglycerides

Question 5

Cholesterol is carried primarily on three different lipoproteins

Answer 5

VLDL
LDL
HDL

Question 6

Most triglyceride molecules are found in?

Answer 6

VLDL particles

Question 7

What is laid down, and is not clearly understood, in injuried/ inflamed blood vessels and starts to form arteriosclerotic plaques

Answer 7

Fat

Question 8

Bad cholesterol

High levels have been shown to accelerate plaque formation

Answer 8

LDL

Question 9

Good cholesterol

Transport cholesterol to your liver to be expelled from your body

Answer 9

HDL

Question 10

Primary prevention

Answer 10

Atherosclerotic vascular virgin
Utilize a ASCVD risk calculator ( risk of MI)
40-79 years old ASCVD >5%

Question 11

Primary treatment for those without prior history of atherosclerotic vascular event 40-79 and a ASCVD greater than 5%

Answer 11

Give a statin

Question 12

Primary prevention
40-79 years old
ASCVD is greater than >10%
What treatment is warranted?

Answer 12

Aspirin therapy

Question 13

Secondary prevention refers to those that have been?

Answer 13

Dx with coronary heart disease aka atherosclerotic plaques

Question 14

Symptoms/physical exam findings

Answer 14

Most are asymptomatic

Or AMI can be a presenting sx

Question 15

High triglyceride levels can cause?

>1000 mg/dL

Answer 15

Formation of eruptive Xanthomas ( red yellow papules, especially on the buttocks

Question 16

High levels of triglycerides ( >2000) can cause

Answer 16

Lipemia retinalis ( cream colored blood vessels in the fundus of the eye)

Question 17

High triglycerides can precipitate ?

Answer 17

Acute pancreatitis

Question 18

High LDL concentrations can lead to?

Answer 18

Tendinous xanthomas on certain tendons( Achilles, patella, and back of hand)

Question 19

Labs ordered

Answer 19

Lipid panel

Other labs if history suggests other etiologies than labs to evaluate those on your differential dx list.

Question 20

Treatments ( no meds)

Answer 20

Low fat diet ( 25-30% reduction of fat) 
Mediterranean diet 
High fiber diets ( 40-45 Parma per day) 
Stop smoking
Aerobic exercise 
Weight loss
Reduction of ETOH

Question 21

Treatments meds

Answer 21

Statins ( HMG-CoA reductase inhibitors)

Simvastatin

Question 22

Complications

Answer 22

AMI
CVA
PAD
Bowel infarct 
Renal infarct

Question 23

Initial management

Answer 23

Lifestyle modifications

Screening patients (20-39) with a lipid panel and calculate ASCVD risk, if >10% chance in next 10 years then start statin therapy if no contraindication

At 40-79 screen with lipid panel and calculate ASCVD risk, if 5% chance in next 10 years then start statin therapy if no contraindications

Question 24

Follow up

Answer 24

Yearly lipid panels and re-calculate ASCVD risk

Yearly LFTs if on Station therapy
Yearly history looking for signs of cardiovascular disease