Dyslipidimia Flashcards

1
Q

Classification of Dyslipidemia

A
• predominant hypertriglyceridaemia
• predominant hypercholesterolaemia
• mixed pattern with elevation of both cholesterol
and triglyceride (TG
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2
Q

Summary of studies that reinforce the benefits of lipidlowering therapy for dyslipidaemia and the primary
prevention of coronary heart disease (CDH).

A

4S, 2 PLACI, 3 PLACII, 4 ACAPS, 5 KAPS 6

and REGRESS

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3
Q

One systematic review showed that ______ and __________ are the most favourable lipid-lowering
interventions, with reduced risks of overall and
cardiac mortality

A

statins and

n-3 fatty acids

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4
Q

Major risk factors for CAD include:
1
2

A

— increased LDL cholesterol + reduced HDL
cholesterol
— ratio LDL-C:HDL-C >4

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5
Q

Risk increases with increasing cholesterol levels

(90% if >_______

A

7.8 mmol/L

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6
Q

TG levels >10 mmol/L increases risk of

________

A

pancreatitis

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7
Q

10% reduction of total cholesterol gives _______

reduction in CAD after 3 years

A

20%

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8
Q

Common causes of secondary

dyslipidaemia

A
Hypothyroidism
Nephrotic syndrome
Type 2 diabetes
Cholestasis
Anorexia nervosa
Obesity
Kidney impairment
Alcohol excess
Obstructive liver disease
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9
Q
Recommended treatment goals
• Total cholesterol \_\_\_\_\_\_\_\_
• LDL-C \_\_\_\_\_\_\_\_\_*
• TG \_\_\_\_\_\_\_
• HDL-C ≥ \_\_\_\_\_\_
• non-HDL-C <2.5 mmol/L
A

<4.0 mmol/L
<2.0 mmol/L
<2 mmol/L
1.0 mmol/L

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10
Q

Dyslip Treatment should commence with a_____

A

statin.

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11
Q

If
LDL-C levels are not reduced to target levels or a
maximally tolerated dose on a statin, add one of
________, _______, ______

A

ezetimibe,bile acid binding resin or nicotinic acid.

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12
Q

SE of statins

A

GIT side effects, myalgia,

abnormal liver function (uncommon

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13
Q

In statin Tx, repeat LFTs after

A

4–8 weeks, then every 6

weeks for 6 months

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14
Q

Combination: ezetimibe + statin (especially if

_________

A

cholesterol below target)

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15
Q

Bile acid binding resins:
• e.g. __________ 4 g daily in fruit juice
increasing to maximum tolerated dose

A

cholestyramine

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16
Q

_________ consider if above drugs not tolerated

A

Fibrates:

17
Q

Adverse effects of nicotinic acid

A

flushing, gastric irritation,

gout

18
Q

Mx of Resistant LDL-C elevation

A
1 Combination statin + ezetimibe
2 Combined statin and resin
cholestyramine 4–8 g (o) mane
plus
a statin
19
Q

Moderate to severe (isolated or

predominant) TG elevation

A

Fibrate:

gemfibrozil 600 mg (o) bd
or
fenofibrate 145 mg (o) daily

20
Q

Massive hypertriglyceridaemia

(TG) 10 mmol/L:

A

fibrate plus fish oil plus (if necessary) nicotinic acid

21
Q

Mixed hyperlipidaemia (↑ TG + ↑ LDL-C)

  • If TG <4: a ________
  • If TG >4: a ________
A

statin

fibrate

22
Q

Statin + gemfibrozil increases risk of

______and requires specialised supervision

A

myopathy