Hyperlipidaemia

Question 1

What are the 4 types of hyperlipidaemia?

Answer 1

1. Common primary hyperlipidaemia
2. Familial Primary hyperlipidaemias
3. Secondary hyperlipidaemia
4. Mixed hyperlipidaemia

Question 2

What is the most common form of hyperlipidaemia?

Answer 2

common primary hyperlipidaemia (70%)

Question 3

What are causes of secondary hyperlipidaemia?

Answer 3

1. Cushing’s syndrome
2. Hypothyroidism
3. Nephrotic syndrome
4. Cholestasis

Question 4

What shows up for secondary hyperlipidaemia?

Answer 4

1. High LDL

2. Treat cause first

Question 5

What happens in mixed hyperlipidaemia?

Answer 5

1. high LDL

2. high triglycerides

Question 6

What are causes of mixed hyperlipidaemia?

Answer 6

1. T2 DM
2. Metabolic syndrome
3. Alochol abuse
4. Chronic renal failure

Question 7

What are the measurements for hypertriglycerideaemia?

Answer 7

• fasting plasma triglyceride level ≥2.3 mmol/L (≥200 mg/dL)

- increased VLDL produced, reduced VLDL clearance or both

Question 8

How do you fully screen for hyperlipidiaemia?

Answer 8

fasting lipid profile

Question 9

What are primary causes of hypertriglycerideamia?

Answer 9

1. Familial hypertriglyceridaemia
2. Familial combined dyslipidaemia
3. Polygenic hypercholesterolaemia
4. Broad beta disease

Question 10

What are secondary causes of hypertriglyceridaemia?

Answer 10

1. Obesity
2. DM
   Hypothyroidism
3. Renal disease
4. CF
5. Lipodystrophies
6. Medicines: e.g. like glucocoritocoids, oestrogens
7. Alcohol abuse

Question 11

What are RF for hypercholesterolaemia?

Answer 11

1. Excess body weight
2. T2DM
3. Hypothyroidism
4. Cholestatic liver disease

Question 12

What are symptoms and signs for hypertriglyceridaemia?

Answer 12

1. Obesity/overweight
2. Diabetes
3. CAD
4. Angina/claudication

Question 13

What are the symptoms and signs of hypercholsesterolaemia?

Answer 13

1. FHx of CAD or dyslpipdaemia
2. Hx CVD
3. Consumption of sat fats
4. Excessive body weight
5. Xanthelasma

Question 14

What are differential diagnosis for hypertriglyceriademia?

Answer 14

1. Diabetes
2. Liver disease
3. Hypothyroidism
4. Renal failure
5. Medicines
6. HIV infection

Question 15

What are DDx for hypercholesterolaemia?

Answer 15

1. Obstructive liver disease
2. Nephrotic syndrome
3. Chronic renal insufficiency
4. Hypothryoidism

Question 16

What investigations would you do for hypertriglycerdiaemia?

Answer 16

1. Fasting triglycerides (12hr)

2. Total cholesterol + HDL (cholesterol is high and HDL is low)

Question 17

What are fasting triglycerides like for hypertriglyceridaemia?

Answer 17

≥2.3 mmol/L (200 mg/dL)

Question 18

What is total cholesterol and HDL like for hypertriglyceridaemia?

Answer 18

cholesterol is high and HDL is low

Question 19

What investigations may you do for hypercholesterolaemia?

Answer 19

1. Lipid profile
2. TSH
3. Lipoprotein a

Question 20

What is lipid profile like in hypercholesterolaemia?

Answer 20

total cholesterol >200 mg/dL

Question 21

What is treatment for hyperlipidaemia?

Answer 21

• 1st line: High-intensity statin e.g. 40-80mg orally once daily and lifestyle modifications
• 2nd line: Ezetimbe
• 3rd line: alieocumab

Question 22

What is treatment for acute chylomicronaemia?

Answer 22

• Hospital admission and supportive care

- IV insulin and dextrose

Question 23

What are possible complications of hypertriglyceridaemia?

Answer 23

1. coronary events

2. acute pancreatitis

Question 24

What are possible complications of hypercholesterolaemia?

Answer 24

1. Ischaemic heart disease
2. PVD
3. Acute coronary syndrome
4. Stroke
5. Erectile dysfunction

Question 25

What are prognosis of hypercholesterolamea and hypertriglcyeridaemia?

Answer 25

• Associated with increased cardiovascular risk

- May cause acute pancreatitis when fasting levels >5.7mmol/L