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Q2 Clin Med Final (Cardiology, Hyperlip) > Hyperlipidemia > Flashcards

Hyperlipidemia Flashcards

1
Q

2 main lipids in blood?

A

Cholesterol

Triglycerides

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2
Q

Chylomicrons are?

A

lipoproteins w/ high TAG content

creamy layer

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3
Q

Source of Chylomicrons?

A

dietary fat

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4
Q

Chylomicron travel route?

A

portal vein ->
liver ->
thoracic duct ->
circulation

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5
Q

Chylomicron purpose?

A

transfer food energy into mm and fat cells

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6
Q

VLDL manufactured where?

A

Liver from stores of fat and carbs

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7
Q

VLDL made mostly of?

A

triglycerides

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8
Q

VLDL metabolized down to?

A

LDL

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9
Q

LDL purpose?

A

deliver cholesterol for cell membranes and to make bile acid in the liver

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10
Q

↑ in LDL leads to?

A

atherosclerosis in arterial endothelium

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11
Q

3 ways to ↓ LDL?

A

1) ↓ cholesterol synth
(HMG-CoA reductase inhibitors - Statins)

2) ↓ cholesterol reabsorption
(plant sterols - omega3, red yeast rice; -ezetimibe)

3) ↑ cholesterol excretion
(bile acid sequestrants)

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12
Q

HDL made where?

A

liver and intestines

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13
Q

HDL made of?

A

apoproteins and cholesterol

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14
Q

HDL do what?

A

reverse cholesterol transport by moving chol into lipoprotiens or directly into live

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15
Q

3 ways to ↑ HDL?

A

1) exercise
2) estrogen
3) alcohol

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16
Q

5 things that ↓ HDL?

A

1) hypertriglyceridemia
2) smoking
3) anabolic steroids
4) genes
5) fat and lazy

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17
Q

3 systems that maintain cholesterol balance?

A

1) extrahepatic organs
2) liver
3) intestines

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18
Q

Acute illness can give what false result on cholesterol tests?

A

falsely low

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19
Q

Total cholesterol levels?

A

< 200 = good
200-239 = borderline
>=240 = high

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20
Q

Triglyceride levels?

A

=500 = very high

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21
Q

LDL levels?

A

=190 = very high

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22
Q

HDL levels?

A

=60 = high

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23
Q

Goal LDL for pt’s w/ CAD or DM?

A

<70

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24
Q

Hypertriglyceridemia is risk factor esp when accompanied by?

A

low HDL

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25
Q

Triglycerides >1000 risk for?

A

pancreatitis

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26
Q

Familial Hypertriglyceridemia definition?

A

cell-surface LDL receptors absent or defective:
homozygotes 8x normal LDL
heterozgotes 2x normal LDL

27
Q

Familial Hypertriglyceridemia causes?

A

unregulated synth of LDL

early CHD

28
Q

Xanthelasma is?

A

cholesterol-filled plaques on skin
(U) medial eyelids
soft, yellow

29
Q

Eruptive Xanthomas are?

A

red-yellow papules on skin

w/ trigly >1000

30
Q

Tuberous Xanthoma are?

A

yellow-orange nodules <= 2cm

(U) knees, elbows

31
Q

Lipemia Retinalis is?

A

cream colored blood vessel in fundus

w/ trigly >2000

32
Q

Coronary Heart Disease (CHD) definition?

A

narrowing of coronary bv,

leading cause of death M and F

33
Q

CHD Non-modifiable risk factors?

A

FH: M 45, F 55

34
Q

CHD modifiable risk factors?

A

HYPERLIPIDEMIA
HTN w/ BP >=140/90
HDL <40
fat and lazy

35
Q

What is a negative risk factor for CHD?

A

HDL >=60

36
Q

Coronary thombosis result of?

A

vulnerable plaques w/i wall of coronary arteries

37
Q

Vulnerable plaques filled w/?

A

lipid core
lipid-laden macrophage foam cells
inflammatory cells

38
Q

Role of lipid-laden macrophage foam cells in vulnerable plaques?

A

make tissue factor that stim rapid coag when in contact w/ blood

39
Q

Statins use to tx CAD why?

A

cholesterol-lowering drugs:
stabilize vulnerable plaques
↓ underlying inflammation
↓ major vascular events

40
Q

Hyperlipidemia tx?

A

diet
exercise
meds

41
Q

Major way to ↑ HDL?

A

exercise

42
Q

HMG-CoA Reductase Inhibitors work how?

A

competitive inhibition of HMG-CoA Reductase

cholesterol synth

43
Q

Statins are first line tx for?

A

↑ LDL

(P) 2º benefit is some ↓ in trigly

44
Q

Lipitor LDL reduction %age and does range?

A

38-54% LDL ↓

10-80 mg

45
Q

Lipitor side-effects?

A 
Myalgias
Elevated LFTs (liver fxn)
46
Q

What test monitors myalgias w/ Lipitor?

A

serum creatine kinase (↑ levels = must ∆ drug)

47
Q

Alway obtain baseline for what when starting Lipitor?

Retest?

A

liver fxn (LFT)

3 month post start of tx

48
Q

Alternate to statins if pt can’t tolerate them?

A

ezetimibe
bile acid requestrants
niacin

49
Q

Fibrates used to tx CAD, mechanism?

A

LOWER TRIGLYCERIDES:
stim lipoprotein lipase
↓ VLDL secretion
stim fatty acid oxydation

50
Q

Fibrates may also affect?

A

↑ HDL slightly

↓ LDL slightly

51
Q

Fibrates best first-line med for whom?

A

diabetics w/ hypertriglyceridemia

52
Q

Fibrate drug names?

A

Lopid
Tricor
Trilipix

53
Q 
Nicotinic Acid (niacin/vit B3)
used to treat CAD, mechanism?
A

MODERATE ↑ HDL
↓ prodxn of VLDL
some ↓ LDL, trigly

54
Q

Nicotinic Acid side effect?

A

cutaneous flushing

result of ↑ prostaglandin D2

55
Q

Bile Acid Sequesterants used to tx CAD, mechanism?

A

forms complex w/ bile acids ->
releases chloride ions ->
prevents reuptake of bile salts ->
bile salt-bound LDL lost in feces

56
Q

Bile Acid Sequesterants results in?

A

↓ LDL

*may ↑ trigly by 10%

57
Q

Bile Acid Sequesterant drug names?

A

Questrant

Colestid

58
Q

Bile Acid Sequesterant side-effects?

A

constipation
flatulence
dyspepsia (indigestion)

59
Q

Cholesterol Absorption Inhibitor tx for CAD, mechanism?

A

↓ absorb of cholesterol at small intestine ->
↓ delivery to liver ->
↓ chol for liver to use ->
↑ clearance of cholesterol from blood

60
Q

Cholesterol Absorption Inhibitor results in?

A

↓ LDL

61
Q

Cholesterol Absorption Inhibitor drug name?

A

Zetia (ezetimibe)

62
Q

Omega-3 FA tx for CAD, results in?

A

↓ trigly

63
Q

Omega-3 FA drug name?

A

Omacor

Lovaza

Q2 Clin Med Final (Cardiology, Hyperlip) (8 decks)

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