Hyperlipidaemia Flashcards
1
Q
What are the risk factors for hyperlipidaemia?
A
- Sedentary lifestyle,
- Poor diet,
- Overweight,
- Type 2 diabetes mellitus,
- Hypothyroidism
- Family history
- cholestatic liver disease
2
Q
what is the presentation of hyperlipidaemia?
A
- Obesity,
- Xanthelasma,
- Tendinous xanthomas (indicates familial hypercholesterolaemia)
- Arcus cornealis (indicates familial hypercholesterolaemia)
3
Q
What is familial hypercholesterolaemia?
A
- Autosomal dominant condition which causes high levels of LDL. If untreated can lead to early CV disease
4
Q
When should you suspect familial hypercholesterolaemia?
A
- Total cholesterol level >7.5 mmol/l
- Personal or family history of premature coronary heart disease
5
Q
Explain the diagnosis of familial hypercholesterolaemia?
A
Use Simon Broome criteria:
- Total cholesterol > 7.5 and LDL >4.9 PLUS
- Tendon xanthoma or DNA based evidence (definitive)
6
Q
What is the management of familial hypercholesterolaemia?
A
- High dose statins (should be discontinued in women 3 months before conception due to risks of defects)
7
Q
What are the investigations for hypercholesterolaemia?
A
- Lipid profile (TC > 5),
- Blood glucose,
- Renal function,
- LFTs,
- TFT
8
Q
What is the first line treatment for hypercholesterolaemia and their MOA?
A
- Statins. They are HMG-CoA reductase inhibitors. Should be given when QRISK > 10%
9
Q
What dose of statins is required?
A
- Primary prevention: 20mg of Atorvastatin.
- Secondary prevetion (eg, following stroke or MI or angina): 80mg of Atorvastatin
10
Q
What are the side effects of statins?
A
- Muscle pain,
- Myositis: DO CK. It 5-10x upper limit then stop statin.
- Abdominal pain,
- Constipation,
- Headache
- Abnormal LFTs
11
Q
What is the non medical management of hypercholesterolaemia?
A
- Weight loss
- Better diet,
- More physical activity,
- Reduce alcohol intake,
- Smoking cessation
