Hyperlipidaemia Flashcards
What are the 4 types of hyperlipidaemia?
- Common primary hyperlipidaemia
- Familial Primary hyperlipidaemias
- Secondary hyperlipidaemia
- Mixed hyperlipidaemia
What is the most common form of hyperlipidaemia?
common primary hyperlipidaemia (70%)
What are causes of secondary hyperlipidaemia?
- Cushing’s syndrome
- Hypothyroidism
- Nephrotic syndrome
- Cholestasis
What shows up for secondary hyperlipidaemia?
- High LDL
2. Treat cause first
What happens in mixed hyperlipidaemia?
- high LDL
2. high triglycerides
What are causes of mixed hyperlipidaemia?
- T2 DM
- Metabolic syndrome
- Alochol abuse
- Chronic renal failure
What are the measurements for hypertriglycerideaemia?
- fasting plasma triglyceride level ≥2.3 mmol/L (≥200 mg/dL)
- increased VLDL produced, reduced VLDL clearance or both
How do you fully screen for hyperlipidiaemia?
fasting lipid profile
What are primary causes of hypertriglycerideamia?
- Familial hypertriglyceridaemia
- Familial combined dyslipidaemia
- Polygenic hypercholesterolaemia
- Broad beta disease
What are secondary causes of hypertriglyceridaemia?
- Obesity
- DM
Hypothyroidism - Renal disease
- CF
- Lipodystrophies
- Medicines: e.g. like glucocoritocoids, oestrogens
- Alcohol abuse
What are RF for hypercholesterolaemia?
- Excess body weight
- T2DM
- Hypothyroidism
- Cholestatic liver disease
What are symptoms and signs for hypertriglyceridaemia?
- Obesity/overweight
- Diabetes
- CAD
- Angina/claudication
What are the symptoms and signs of hypercholsesterolaemia?
- FHx of CAD or dyslpipdaemia
- Hx CVD
- Consumption of sat fats
- Excessive body weight
- Xanthelasma
What are differential diagnosis for hypertriglyceriademia?
- Diabetes
- Liver disease
- Hypothyroidism
- Renal failure
- Medicines
- HIV infection
What are DDx for hypercholesterolaemia?
- Obstructive liver disease
- Nephrotic syndrome
- Chronic renal insufficiency
- Hypothryoidism
What investigations would you do for hypertriglycerdiaemia?
- Fasting triglycerides (12hr)
2. Total cholesterol + HDL (cholesterol is high and HDL is low)
What are fasting triglycerides like for hypertriglyceridaemia?
≥2.3 mmol/L (200 mg/dL)
What is total cholesterol and HDL like for hypertriglyceridaemia?
cholesterol is high and HDL is low
What investigations may you do for hypercholesterolaemia?
- Lipid profile
- TSH
- Lipoprotein a
What is lipid profile like in hypercholesterolaemia?
total cholesterol >200 mg/dL
What is treatment for hyperlipidaemia?
- 1st line: High-intensity statin e.g. 40-80mg orally once daily and lifestyle modifications
- 2nd line: Ezetimbe
- 3rd line: alieocumab
What is treatment for acute chylomicronaemia?
- Hospital admission and supportive care
- IV insulin and dextrose
What are possible complications of hypertriglyceridaemia?
- coronary events
2. acute pancreatitis
What are possible complications of hypercholesterolaemia?
- Ischaemic heart disease
- PVD
- Acute coronary syndrome
- Stroke
- Erectile dysfunction
What are prognosis of hypercholesterolamea and hypertriglcyeridaemia?
- Associated with increased cardiovascular risk
- May cause acute pancreatitis when fasting levels >5.7mmol/L
