Hyperlipidaemia

Question 1

lifestyle advice:

aim for what BMI?

Answer 1

20-25

Question 2

Treatment priorities:

patients with which medical conditions?

AND/OR

those with what 10 year risk of CVD?

Answer 2

CVD or DM

QRISK >20%

Question 3

Tx:

1st line therapy:

• for those with T1DM or >10% Qrisk
• for those with known CVD/IHD?

2nd line therapy?

Answer 3

atorvastatins 20mg OD

atorvastatin 80mg OD

2nd line :

fibrates - bezafibrate

cholesterol absorption inhibitors - ezetimibe

Question 4

A 45-year-old man comes to see you recent as his recent blood tests have shown a total cholesterol of 6.2 mmol/L. You ask him to come in so that you can discuss this further. You calculate his Q-risk score to be 23%.

He smokes 10 cigarettes a day and has been smoking for the past 20 years. His father died of a heart attack aged 50. His past medical history includes asthma.

Which one of the following medications would you ask him to start?

atorvastatin 20mg 
atorvastatin 40mg 
atorvastatin 80mg 
simavastatin 10mg 
simvastatin 20mg

Answer 4

atorvastatin 20mg

Atorvastatin 20mg is a high-intensity statin and should be started as primary prevention against cardiovascular disease. Atorvastatin 80mg is used in secondary prevention.

Simvastatin 10mg and 20mg are low-intensity statins.

Question 5

Which of the following secondary causes of hyperlipidaemia result in predominantly hypercholesterolaemia, as opposed to hypertriglyceridaemia?

DM
alcohol
nephrotic syndrome
obesity

Answer 5

nephrotic syndrome