Hyperlipidaemia Flashcards
What mainly causes stable & unstable angina?
Reduced blood flow to the heart muscles (due to blockages/atherosclerosis)
What are some examples of non-modifiable risk factors for CV disease?
- Age
- Gender
- Ethnicity
- Family history/genetics
What are some examples of modifiable risk factors for CV disease?
- Smoking
- Cholesterol levels
- BP
- Lack of exercise
- Excess alcohol consumption
- Diabetes
- Weight/dietary factors
In which organ is cholesterol synthesised in?
The liver.
What is the simplest form of lipids?
Fatty acids.
Where are triglycerides stored?
In adipose tissue.
What are the 4 types of lipoprotein particles?
- Chylomicrons
- VLDL
- LDL
- HDL
Which type of lipoprotein particle is associated with atherosclerosis?
LDL deposits.
Which type of lipoprotein particle prevents atherosclerosis from occurring?
HDL.
What is the exogenous pathway of lipid metabolism?
- Chylomicrons are formed via dietary lipids from the small intestine
- It is then hydrolysed & released as free fatty acids, into adipose tissue
- Some also undergo further delipidation & form chylomicron remnants
- They are then taken up by the liver ready for the endogenous pathway
What is the endogenous pathway of lipid metabolism?
- Free fatty acids/cholesterol get converted to large VLDL in the liver
- This then enters the blood & undergoes delipidation, & converted to LDL
- This LDL can bind to its receptors
- Excess LDL can be up-taken by the liver via HDL
What does LDL & HDL stand for, & which is ‘good’ and ‘bad’?
LDL (bad): low-density lipoproteins
HDL (good): high-density lipoproteins
How can HDL be lowered?
- Smoking
- Obesity
- Physical inactivity
What is metabolic syndrome?
It is a cluster of conditions that occur together which increase your risk of having a CV event. Conditions include:
- Dyslipidaemia
- Hypertension
- Insulin resistance
What is the difference between primary & secondary prevention?
Primary: has never had an incident, but preventing a future event from occurring
Secondary: has had a previous incident, and wanting to prevent a 2nd event
What are the 2 classifications of hyperlipidaemia?
- Inherited
2. Secondary: e.g. hypothyroidism, alcohol, diabetes, liver/renal disease
What is familial hypercholesterolaemia (FH)?
It is an inherited disease due to mutated genetics, causing high LDL deposits.
What one symptom is very specific for FH?
Tendon xanthoma.
It is a collection of cholesterol under the skin, causing yellow/deformed linings.
What is corneal arcus?
It is a grey area in the iris due to cholesterol build up.
What is the Simon-Broome criteria and what 3 things are used to help in diagnosing?
It is used to diagnose FH. It accounts for:
- Total cholesterol
- LDL levels
- Family history of CVD
What is the QRISK-3 calculator?
It is a system which shows your risk of having a heart attack within the next 10 years (by inputting your details)
What is the max. number of units of alcohol recommended /week?
14 units
Which drug class is the most potent for treating high cholesterol?
Statins.
What is the mode of action of PCSK9 inhibitors?
- PCSK9 usually removes LDL receptors by degrading them into lysosomes
- By inhibiting this, more LDL can bind to its receptors & be taken up.
What process do statins inhibit?
Cholesterol synthesis.
They inhibit HMG CoA reductase from converting acetyl coA to cholesterol.
Which statin is the most potent?
Rosuvastatin.
