Hyperlipidaemia Flashcards
1
Q
What is hyperlipidaemia?
A
elevated blood lipid levels (total cholesterol, LDL, triglycerides)
2
Q
What are the causes of hyperlipidaemia?
A
obesity, diabetes, physical inactivity, hypothyroidism, nephrotic syndrome, alcohol, cholestatic liver disease, Familial Hypercholesterolaemia (FH)
3
Q
What is Familial Hypercholesterolaemia (FH)?
A
- Autosomal dominant inherited disorder
- Caused by a mutation in the gene coding the LDL receptor
- Causes early-onset hypercholesterolaemia and hyperlipidaemia, leading to cardiovascular disease in young patients.
4
Q
What are the presenting symptoms of hyperlipidaemia?
A
- Xanthomata → nodular lipid deposits in the skin and tendons
- Xanthelasma → yellow, flat plaques on upper eyelids
- Corneal Arcus → crescentic-shaped opacity at the periphery of the cornea
5
Q
What investigations are used to diagnose/ manage hyperlipidaemia?
A
- Lipid Profile → total cholesterol, HDL, LDL and trigylcerides
- Tests for Secondary Causes → HbA1c/Fasting glucose, TSH, LFTs, urinalysis, LFTs
- QRISK2 → screens for risk of cardiovascular disease.
6
Q
How is hyperlipidaemia managed?
A
- Lifestyle Modifications (QRISK <10%) → improve diet, physical activity, weight management, alcohol intake, smoking cessation
- 1st Line (if QRISK ≥10%) → atorvastatin 20mg (alternative = simvastatin) - decrease cholesterol synthesis by inhibiting HMG-CoA Reductase
- Secondary Prevention (known IHD/Cerebrovascular Disease/PAD) → atorvastatin 80mg
- Statins ⇒ contraindicated in pregnancy
- Important interactions with erythromycin/clarithromycin (macrolides) (can cause myopathy, increased likelihood of rhabdomyolysis)
- Taking last thing at night improves efficacy
- Treatment with statins should be discontinued if serum transaminase concentrations rise to and persist at 3 times the upper limit of the reference range - 2nd Line (if statin intolerance) → ezetimibe - cholesterol absorption inhibitor
