Hyperlipidemia Flashcards
Who to screen for hyperlipidemia
Everyone over 40.
Women after pregnancy who had hypertension during pregnancy
What factors are included in a framingham risk score
sex age Total cholesterol HDL Smoking Systolic BP If they are on BP treatment
Who can you not use a framingham on (not validated for)
South east asians
First Nations
new immigrants
What is one test you can get in the acute setting to see someones risk of Mi or stroke and who would you get it on
Coronary artery calcium
Get in someone who is asymptomatic with intermediate risk (10-20%)
Someone over 40
Someone with a family history of premature cardiac events
When does someone need to fast for the blood work
If TG >4.5
Lifestyle suggestions for dyslipidemia
Exercise 150 minutes per week
Mediterranian diet
Omega-3 (reduces TG but does not improve CV outcomes)
-Effective and safe with reduction of about 25% in TG but no impact on LDL
-Some GI side effects
Consider for high TG
Use Lcosapent Ethyl
Smoking cessation
Drink less
Lose weight (lose 5% of body weight reduces VCD risk by 6%
Sufficient sleep
Combine these things and CVD risk and mortality drops by 75%
List 5 referrals you can make
Dietician Counseling Smoking cessation Cardiology Endocrinology Kinesiology
List three medications you can use for high CVD risk in the setting of high cholesterol
Statin
Ezetimibe (2-Azetidinone)
Alirocumab (PCSK9 inhibitors)
Inclisiran (does not actually improve CV benefit yet, but reduces LDL by about 50%)
List seven risk factors for high cholesterol
Old Male Smoker Diabetes HTN Family history Metabolic syndrome Inflammatory markers
List ten reasons you would screen someone earlier than 30
Smoker Obese Diabetes HTN Gestational HTN COPD Erectile dysfunction Family history Inflammatory disease CKD HIV AAA South Asian or First nations
List ten drugs that can cause high LDL or TG
LDL Steroids, amiodarone, retinoids, diuretics
TG: Estrogen, steroids, betablockers, antipsychotics, retinoids, tamoxifen, thiazides
List five medical conditions that can cause increased LDL or TG
Nephrotic syndrome Hypothyroid Pregnancy Anorexia Diabetes Ovesity Inflammatory states
You start someone on a statin and they come to you with muscle aches. What do you do
CK, LFTs, Bilirubin
Who is at higher risk of a statin induced myopathy
Olds High dose Low BMI Hypothyroid (if untreated) CKD Alcohol abuse Liver disease Excessive physical activity
How to treat statin myopathies
Lower dose (better than no dose) Consider rehydration of CK >10x normal
