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Clin Med > Exam4 Hyperlipidemia > Flashcards

Exam4 Hyperlipidemia Flashcards

1
Q

high HDL is..

A

cardioprotective. can cancel out high ldl

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2
Q

risk of MI inc. 25% for every…

A

%5 decrease of HDL

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3
Q

HDL increased by…

A

work out, drink, estrogen

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4
Q

HDL decreased by…

A

HyperTAG, tobacco, obesity, roids.

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5
Q

2 main lipids in blood…

A

Cholesterol, Triglycerides

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6
Q

Cholesterol forms

A

backbone of steroid hormones and bile acids

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7
Q

Triglycerides transfer

A

energy from food into cells

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8
Q

lipoproteins carry both

A

triglycerides and cholesterol

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9
Q

Higher lipid content= lower the density. Order high to low lipid content (Cody Very Large Head)

A

Chylomicrons, VLDL, LDL, HDL

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10
Q

Chylomicrons, via diet fat, energy from food—> muscle and fat cells

A

portal vein—>liver, thoracic duct—-> circulation

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11
Q

VLDL, liver makes it from fat/carbs stores. Made mostly of..

A

TAG

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12
Q

VLDL—> LDL

A

LDL is ‘bad’ cholesterol

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13
Q

bad cholesterol because…

A

LDL mostly taken up by liver (becomes bile), while LDL in arteries leads to atherosclerosis

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14
Q

Familial Hypercholesterolemia…

A

defect in LDL receptor

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15
Q

LDL cholesterol where is makes cell membrane and bile acid

A

yucky

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16
Q

Reduce LDL, lower chol. synth via…

A

HMG-CoA reductase inhibitor STATINS

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17
Q

Reduce LDL, inc. cholesterol excretion via…

A

bile acid sequestrants block resorption, poop out cholesterol

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18
Q

Reduce LDL, reduce chol. absorption

A

Plant stanol esters, Ezetimibe

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19
Q

HDL made in liver and intestines, does what?

A

Reverse cholesterol transport (Transfer chol into other lipoproteins or into liver)

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20
Q

Net cholesterol balanced by 3 systems…

A

extrahepatics, liver, intestines

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21
Q

cholesterol balance…

A

chol. synth/absorption vs. chol. excretion

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22
Q

Fasting lipid panel (not for pregnant pt.)

A

TAG affected by eating, cholesterol is not

23
Q

Desired level for TOTAL Cholesterol=

A

< 200

24
Q

Best level for TAG=

A

< 150

25
Q

< 100=

A

Best level for LDL, but you want <70 if CAD or DM!!

26
Q

HDL levels: What’s high? low?

A

60+ is High, <40 Low

27
Q

Low LDL can suggest…

A

AIDS, liver disease, Hyperthyroid, Chronic Anemia, etc. LOW LDL NOT ALWAYS GOOD

28
Q

Checking w/ 12 hour fast, HyperTAG=

A

obesity, DM, lover disease, EtOH, Accutane

29
Q

pancreatitis, eruptive skin xanthomas

A

HyperTAG >1000

30
Q

Familial Hypercholesterolemia (absent LDL receptors)=

A

Early CHD

31
Q

simvastatin targets LDL

A

TAG targeted by fibrate, niacin.

32
Q

Hyperlipidemia has no symptoms, while Xanthelasma presents with…

A

yellow medial eyelids

familial hypercholesterolemia

33
Q

HyperTAG >2000

A

creamy fundus= Lipemia Retinalis

34
Q

Coronary Heart Disease via high Cholesterol

A

some risk factors you can’t change, but you CAN change…
HYPERLIPIDEMIA
HTN
HDL 60+ or <40

35
Q

How does LDL or HDL work?

A

nobody knows

36
Q

LDL? More like LameDL

A

HDL? More like HappyDL

37
Q

Lipid core, lipid-laden macrophage foam and inflammatory cells= vulnerable plaques

A

tissue factor—> pro-coagulation—> stimulates thrombus, results in MI

38
Q

STATINS for CAD, bring LDL to…

A

<70, but also treat ALL aspects of CAD

39
Q

Tx diet, exercise, meds for…

A

Hyperlipidemia

40
Q

diet to lower LDL, BP, CHD, stroke=

A

little red meat, more of the good stuff

41
Q

Exercise increases..

A

HDL! 30 minutes moderate/daily

42
Q

HMG-CoA Reductase Inhibitors (Statins)

A

FIRST LINE Tx to lower LDL, usually taken at night

43
Q

rate-limiting step of cholesterol biosynth?

A

HMG-CoA

44
Q

Statins benefit pts. with CHD, HTN, Hyperlipidemia, high total cholesterol, high LDL.
SIDE EFFECTS?

A

Myopathy- try to switch statins if so. Serum Creatine Kinase checks for Myopathy
Elevated LFTs- try EZETIMIBE if so.

45
Q

Simvastatin in high dose can lead to

A

Myopathy

46
Q

Fibrates used for?

A

HyperTAG. FIRST LINE for diabetics c hyperTAG

47
Q

Nicotinic Acid (Niacin) used for?

A

increases HDL (watch for flushing)

48
Q

How to lower LDL?

A

Bile acid sequestrants (statins are better)

49
Q

use bile acid sequestrants in pts with hyperTAG?

A

NO! bas can raise TAG

50
Q

Ezetimibe inhibits…

A

absorption of cholesterol. lowers LDL

51
Q

Fish Oils decrease TAG

A

decrease TAG with fish oils

52
Q

Fibrates and Fish Oils decrease…

A

TAG. ok i get it.

53
Q

SUMMARIZE PREFERRED LEVELS HERE

A

SUMMARIZE Rx HERE

Clin Med (15 decks)

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