Hyperlipidaemia Flashcards

1
Q

What is hyperlipidaemia?

A

Hyperlipidaemia is a condition characterised by elevated levels of lipids (cholesterol and/or triglycerides) in the blood.

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2
Q

What are the main types of hyperlipidaemia?

A

Primary (genetic) hyperlipidaemia and secondary hyperlipidaemia due to underlying conditions or lifestyle factors.

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3
Q

What are the common causes of secondary hyperlipidaemia?

A

Causes include diabetes, hypothyroidism, obesity, chronic kidney disease, excessive alcohol consumption, and certain medications.

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4
Q

What is the pathophysiology of hyperlipidaemia?

A

It involves the accumulation of lipids in the blood due to increased production, decreased clearance, or both, leading to atherosclerosis.

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5
Q

What are the risk factors for hyperlipidaemia?

A

Poor diet, sedentary lifestyle, obesity, smoking, family history of hyperlipidaemia, and conditions like diabetes and hypothyroidism.

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6
Q

What are the clinical features of hyperlipidaemia?

A

It is often asymptomatic but may present with xanthomas, xanthelasma, corneal arcus, or symptoms of cardiovascular disease.

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7
Q

What are xanthomas, and how are they related to hyperlipidaemia?

A

Xanthomas are lipid deposits in the skin or tendons, commonly associated with severe hyperlipidaemia.

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8
Q

What investigations are used to diagnose hyperlipidaemia?

A

Lipid profile (total cholesterol, LDL, HDL, triglycerides), liver function tests, thyroid function tests, and fasting glucose or HbA1c.

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9
Q

What is the significance of LDL cholesterol in hyperlipidaemia?

A

LDL cholesterol is considered the “bad” cholesterol and is a key target in reducing cardiovascular risk.

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10
Q

What is familial hypercholesterolaemia?

A

A genetic disorder characterised by significantly elevated LDL cholesterol levels and increased risk of early-onset cardiovascular disease.

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11
Q

How is familial hypercholesterolaemia diagnosed?

A

It is diagnosed using clinical criteria such as Simon Broome or Dutch Lipid Clinic Network criteria, supported by genetic testing.

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12
Q

What are the complications of untreated hyperlipidaemia?

A

Complications include atherosclerosis, myocardial infarction, stroke, and peripheral arterial disease.

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13
Q

What are the management goals for hyperlipidaemia?

A

To lower LDL cholesterol levels, reduce cardiovascular risk, and manage associated comorbidities.

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14
Q

What lifestyle modifications are recommended for hyperlipidaemia?

A

A healthy diet low in saturated fats, regular physical activity, smoking cessation, weight loss, and limiting alcohol intake.

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15
Q

What is the first-line medical treatment for hyperlipidaemia?

A

Statins, such as atorvastatin or simvastatin, are the first-line therapy for lowering LDL cholesterol.

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16
Q

How do statins work?

A

Statins inhibit HMG-CoA reductase, reducing cholesterol synthesis in the liver and lowering LDL levels.

17
Q

What are common side effects of statins?

A

Muscle pain, fatigue, liver enzyme abnormalities, and, rarely, rhabdomyolysis.

18
Q

What are alternative lipid-lowering therapies if statins are not tolerated?

A

Ezetimibe, bile acid sequestrants, PCSK9 inhibitors, or fibrates may be used.

19
Q

What is the role of fibrates in hyperlipidaemia management?

A

Fibrates lower triglycerides and can modestly increase HDL cholesterol.

20
Q

How are triglycerides managed in hyperlipidaemia?

A

High triglycerides are managed with lifestyle changes, fibrates, or omega-3 fatty acid supplements if necessary.

21
Q

What is the role of PCSK9 inhibitors in hyperlipidaemia?

A

PCSK9 inhibitors, such as evolocumab, significantly lower LDL cholesterol and are used in high-risk patients.

22
Q

What is the QRISK score, and how is it used in hyperlipidaemia?

A

The QRISK score estimates the 10-year risk of cardiovascular events, guiding decisions on starting lipid-lowering therapy.

23
Q

What are the treatment thresholds for starting statins in hyperlipidaemia?

A

Statins are typically recommended for patients with a QRISK score ≥ 10%, established cardiovascular disease, or familial hypercholesterolaemia.

24
Q

How is hyperlipidaemia monitored during treatment?

A

Lipid profiles are checked 3 months after initiating therapy, and adherence to lifestyle changes and medications is reviewed regularly.

25
Q

Why is early identification and treatment of hyperlipidaemia important?

A

Early treatment reduces the risk of cardiovascular complications, improving long-term outcomes and quality of life.