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Cardiology SB > Hyperlipidaemia > Flashcards

Hyperlipidaemia Flashcards

1
Q

what are the stages of atherothrombosis

A 
1 - normal
2 - fatty streak
3 - fibrous plaque
4 - atherosclerotic plaque
5 - plaque rupture/fissure & thrombosis
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2
Q

at what stage is there angina/TIA/PAD

A

Fibrous plaque

Atherosclerotic plaque

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3
Q

what is the pathogenesis of atherosclerotic plaques

A 
1 - endothelial damage
2 - protective response results in production of cellular adhesion molecules
3 - monocytes + T lymphocytes attach
4 - migrate through wall
5 - lipid rich foam cells
6 - fatty streak and plaque
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4
Q

what are the big 4 of CV risk factors

A

Hypertension
Hypercholesterolemia
Smoking
Diabetes/obesity

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5
Q

what are the little 4 of CV risk factors

A

Physical inactivity
Alcohol
Stress
Biological factors

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6
Q

what are the types of lipoproteins

A 
Chylomicrons
Very low-density lipoproteins
Intermediate-density lipoproteins
Low density lipoprotein
High density lipoprotein
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7
Q

what lipoprotein is strongly associated with atherosclerosis and CHD events

A

LDL cholesterol

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8
Q

what does a raised triglycerides make you susceptible to

A

increased risk of CHD

increased pancreatitis risk

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9
Q

which cholesterol has a protective quality and what is it’s relationship with CHD

A

HDL

lower HDL, higher risk for CHD

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10
Q

what is the relationship between triglycerides and HDL cholesterol

A

HDL tends to be low when Triglycerides is high

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11
Q

what lowers HDL

A

smoking, obesity, physical inactivity

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12
Q

what is the exogenous metabolic pathway concerned with

A

the transport and utilisation of dietary fat

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13
Q

what happens in the GI tract

A

Dietary fat is broken down into cholesterol, fatty acids and mono- and di-glycerides.
Together with bile acid they carry lipid to absorptive sites in the duodenum

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14
Q

what happens after absorption in the duodenum

A

chylomicrons are formed which enter the blood stream to be transported to the liver

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15
Q

what hydrolyse the chylomicrons once in enters the plasma and what does it do

A

lipoprotein lipase

releases the triglyceride core, free fatty acids and mono- and diglycerides for energy production or storage

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16
Q

what happens to the residual chylomicron

A

further dilipidation resulting in the formation of chylomicron remnants

17
Q

what happens to the chylomicron remnants

A

taken up by the liver and undergo lysosomal degradation

are either used for cell membrane synthesis or excreted as bile salts

18
Q

how much of the triglyceride is absorbed

A

virtually all

19
Q

what does VLDL do

A

transports triglycerides from the liver to the rest of the body

20
Q

what enzymes causes VDLD to undergo delipidation

A

lipoprotein lipase

21
Q

what happens to VLDL

A

transformed into LDL

the larger VLDL particles are lipolysed to IDL

22
Q

what enzyme reacts with smaller VLDL and IDL particles

A

hepatic lipase

23
Q

what is the product of the endogenous pathway and what happens to it

A

LDL

absorbed by macrophages within the arterial wall to form lipid-rich foam cells

24
Q

what is the mechanism of action of statins

A

inhibits HMG-CoA reductase - the enzyme involved in the rate-limiting step in the formation of cholesterol

25
Q

what do statins do

A

reduce total cholesterol and LDL cholesterol

increase NO availability

26
Q

what are clinical markers for dyslipidaemia

A 
Xanthelasma
Tendon xanthomas
Tuberous xanthomas
Eruptive xanthomas
Striate palmar xanthomas
27
Q

what are xanthelasma

A

xanthomas of eyelids

may or may not be associated with hyperlipidemia

28
Q

what are tendon xanthomas

A

infiltration of tendon by lipid

29
Q

what are tuberous xanthomas

A

lipid deposits in the dermis and subcutis

30
Q

what are tuberous xanthomas indicators of

A

familial or acquired hypertriglyceridemias

biliary cirrhosis

31
Q

what is eruptive xanthomas

A

small reddish-yellow papules

seen on buttocks, posterior thighs, body folds

32
Q

what happens in association with eruptive xanthomas

A

abrupt increase in serum triglyceride levels

33
Q

what are the two types of hypertension

A

essential - no underlying cause

secondary - underlying cause

34
Q

what does smoking do

A

Increases blood pressure
Decreases HDL
Damages arteries and blood cells
Increases risk of heart attacks

35
Q

how does type 2 diabetes mellitus lead to atherosclerosis

A

increased LDL, VLDL
Decreased HDL
increased oxidative stress-endothelial dysfunction-vascular damage-smooth muscle cell proliferation
increased platelet adhesiveness-hypercoagulation

Cardiology SB (15 decks)

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