Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pre-reg Exam 2021 > Hyperlipidaemia > Flashcards

Hyperlipidaemia Flashcards

1
Q

What is hyperlipidaemia?

A

High blood levels of cholesterol, triglycerides or both

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What does hyperlipidaemia cause?

A 
Atherosclerosis 
CHD
Strokes
TIA
Peripheral arterial disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

When is primary prevention of cardiovascular disease needed?

A

T1DM

T2DM if CVD risk > 10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

When is secondary prevention of CVD needed?

A

When the patient has established CVD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

When is the QRISK score needed?

A

84 and under

10 year CVD risk score > 10% offer primary prevention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

When is QRISK unsuitable?

A 
T1DM
Established CVD
85+
CKD
Familial hypercholesterolaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the levels of total cholesterol needed for hyperlipidaemia to be diagnosed?

A

6mmol/L total cholesterol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the cholesterol targets for healthy adults?

A

< 5 mmol/L total
< 3 mmol/L LDL
> 1 mmol/L HDL
< 1.7 mmol/L triglycerides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the cholesterol targets for high risk adults?

A

< 4mmol/L total
< 2 mmol/L LDL
> 1 mmol/L HDL
< 1.7 mmol/L triglycerides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What drugs cause hyperlipidaemia?

A

Antipsychotics
Immunosuppressants
Corticosteroids
Antiretrovirals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What conditions cause hyperlipidaemia?

A 
Hypothyroidism
Liver or kidney disease
Diabetes
Family history
Lifestyle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the statins?

A 
Atorvastatin
Simvastatin
Rosuvastatin
Pravastatin
Fluvastatin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the fibrates?

A

Bezafibrate
Ciprofibrate
Fenofibrate
Gemfibrozil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the bile acid sequestrants?

A

Colesevelam
Colestipol
Colestyramine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the nicotinic acid group?

A

Acipimox
Nicotinic acid
Omega 3 fatty acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the other lipid regulating drugs?

A

Ezetimibe
Lomitapide
Alirocumab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the mechanism of action of statins?

A

Lowers LDL cholesterol synthesis by the liver via inhibition of HMG-CoA reductase

Indirectly reduces triglycerides and increases HDL cholesterol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Which statin does not need to be taken at night?

A

Atorvastatin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are high intensity statins used for?

A

Prevention of cardiovascular disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the high intensity statins?

A

Atorvastatin
- primary prevention 20mg OD
- secondary prevention 80mg OD
Rosuvastatin 10mg

Simvastatin 80 mg

21
Q

What is the MHRA warning for simvastatin 80mg?

A

High risk of myopathy

Only give if high risk of CVD complications or severe hypercholesterolaemia and treatment goals not achieved at a lower dose

22
Q

Are statins used for hyperlipidaemia?

A

Yes, first line

23
Q

What are secondary causes of dyslipidaemia?

A

Hypothyroidism
Uncontrolled diabetes mellitus
Nephrotic syndrome
Liver disease

24
Q

What are the side effects of statins?

A

Myopathy, myosotis, rhabdomyolysis
Interstitial lung disease
Diabetes

25
Q

What are the counselling points of statins?

A

Report tender, weak and painful muscles
Report short breath, cough, weight loss
Can raise HBA1c

26
Q

When is there an increased risk of muscle toxicity in statins?

A

History of muscle disorder
High alcohol
Renal impairment
Hypothyroidism

27
Q

When is there an increased risk of myopathy with the use of statins?

A

Ezetimibe or fibrates

Fusidic acid - restart statin 7 days after last dose

28
Q

What are the monitoring requirements for statins?

A 
Baseline lipids
Renal function
Thyroid function 
HBA1c
Severe muscle symptoms - discontinue 
Creatinine kinase - discontinue if 5X normal

Liver function - discontinue if liver transaminases 3x normal

29
Q

What is the MHRA warning for amlodipine and statins?

A

Do not take more than 20mg simvastatin when taking amlodipine concomitantly

30
Q

What are the interactions with statins that causes an increase in statin levels?

A 
Amiodarone
Grapefruit juice
CCBs
Imidazole/triazole antifungals
Macrolides 
Ezetimibe/fibrates
Fusidic acid
31
Q

What are the counselling points needed for patients taking statins when they have been given a macrolide prescription e.g. Clarithromycin?

A

Stop taking statin until antibiotic course completed

32
Q

When do you restart statin after taking oral fusidic acid?

A

7 days after last fusidic acid dose

33
Q

What re the dose adjustments needed for simvastatin due to interactions?

A

Max 10 mg with fibrate

Max 20mg with amiodarone, amlodipine, diltiazem, verapamil

34
Q

What is the dose adjustment required for atorvastatin when used with ciclosporin?

A

Max 10mg atorvastatin

35
Q

What is the dose adjustment required for rosuvastatin with clopidogrel?

A

Initially 5mg

Max 20mg

36
Q

Can statins be taken in pregnancy?

A

NO - teratogenic

Effective contraception during and 1 month after stopping

Stop taking 3 months before conceiving and restart after breastfeeding finished

37
Q

What conditions can cause dyslipidaemia?

A

Hypothyroidism
Uncontrolled diabetes mellitus
Nephrotic syndrome
Liver disease

38
Q

What is the mechanism of action of ezetimibe?

A

Reduces blood cholesterol by inhibiting the absorption of cholesterol by the small intestine

Alternative to statin in familial and primary hypercholesterolaemia

39
Q

What is the interaction between statins and ezetimibe?

A

Myopathy (rhabdomyolysis)

40
Q

What is the mechanism of action of fibrates?

A

Lowers blood triglyceride levels by reducing the livers production of VLDL and by speeding up the removal of triglycerides from the blood

41
Q

What is severe hypertriglyceridaemia?

A

Levels above 10mmol/L

42
Q

What are the fibrates?

A

Bezafibrate
Fenofibrate
Ciprofibrate
Gemfibrozil

43
Q

Which fibrate is contraindicated when used with a statin?

A

Gemfibrozil

Do NOT use with statin as high risk of myopathy (rhabdomyolysis)

44
Q

What are the interactions between fibrates and statins?

A

Causes myopathy

45
Q

What happens if a patient has renal impairment and uses fibrates?

A

Can cause myopathy

46
Q

What is the mechanism of action of bile acid sequestrants?

A

Binds and sequesters bile acids

Liver produces more bile acids to replace those that have been lost

Cholesterol is used to make bile acids, reducing the amount of LDL cholesterol circulating in the blood

47
Q

What are the bile acid sequestrants?

A

Colesevelam
Colestipol
Colestyramine

48
Q

What are the interactions of the bile acid sequestrants?

A

Impairs absorption of fat soluble vitamins ADEK and other drugs

49
Q

When should you take bile acid sequestrants in relation to other drugs?

A

Take other drugs one hour before (4 hours for colesevelam) or 4 hours after bile acid sequestrants

Pre-reg Exam 2021 (79 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions