Hyperlipidaemia/Hypercholsteraemia (Complete) Flashcards
Define hypercholesteraemia
Raised serum levels of one or more of total cholesterol
What differentiates hypercholesteraemia from hyperlipidaemia?
Hypercholesteraemia: High levels of LDL or total cholesterol which DOESNT include triglycerides [Subtype of hyperlipidaemia]
Hyperlipidaemia: Above normal lipids INCLUDING triglycerides [Moresoe umberall term]
What are secondary causes of hypercholesteraemia?
Familial dyslipidaemias
Familial hypercholesterolaemia
Apoprotein disorders
Medical conditions
Drugs: eg. thiazide diuretics, glucocorticoids, ciclosporin
Pregnancy
Obesity
Alcohol abuse
List examples of medical conditions associated with hypercholesteraemia (5)
Hypothyroidism
Obstructive jaundice
Cushings syndrome
Nephrotic syndrome
Chronic Kidney Disease
List examples of drugs which can cause hypercholesteraemia (3)
Thiazide diuretics
Corticosteroids
Ciclosporin
What is the inheritance pattern of familial hypercholesteraemia?
Autosomal dominant
What are the main features of familial hypercholesteraemia?
Premature arcus senilis/corneal arcus (grey ring around eye)
Tendon xanthomata
What investigations should be done for patients suspected of hypercholesteraemia?
Bloods:
Lipid profile: Raised cholesterol
U&Es: Renal function
LFTs: Liver function
Blood glucose
Thyroid function: Hypothyroidism
What findings are suggestive of hypercholesteraemia?
High total cholesterol
High LDL-cholesterol
Low HDL-cholesterol
What findings point towards familial hypercholesteraemia?
Total cholesterol >7.5 [Very high]
OR Family history of premature cardiac disease (cardiac event <60 years of age in family)
What criteria is used to clinically diagnose familial hypercholesteraemia?
Simon Broome criteria:
How is familial hypercholesteraemia managed?
High dose statins
Management algorithm of hyperlipidaemia
What are side effects of statins?
Muscle pain (If myositis, significantly raised creatinine then statin should be stopped)
Abnormal liver function (ALT/AST 3x above upper limit)
Abdominal pain
Constipation
Headache
When should statins be stopped?
Macrolides (e.g. clarithromycin, erythromycin)
Myositis (Very elevated creatinine kinase and severe myalgia)
If LFTs (ALT/AST) 3x above upper limit
Pregnancy (Teratogenic)
