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Hyperlipidemia Flashcards

1
Q

syndrome in which measured serum lipid components deviate from optimal levels

A

hyperlipidemia

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2
Q

genetic mutation in the gene encoding the LDL receptor protein that causes elevated plasma cholesterol and premature CAD

A

familial hypercholesterolemia

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3
Q

familial hypercholesterolemia should be suspected in patients with _____ _____

A

tendon xanthomas

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4
Q

characterized as elevated triglycerides, LDL and early CAD

A

familial combined hyperlipidemia

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5
Q

mutation in apo B-100 that inhibits its binding to the LDL receptor that causes elevations in LDL

A

familial defective apolipoprotein B-100

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6
Q

what might present with severe hypercholesterolemia, tendon xanthomas, and premature atherosclerosis?

A

familial defective apolipoprotein B-100

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7
Q

what is increased levels of Lipoprotein A - Lp(a) - a risk factor for? (2)

A

CAD
stroke

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8
Q

what does a patient have if they present with elevations in cholesterol, triglycerides, and are likely to develop premature CAD?

A

remnant removal disease

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9
Q

what are the top 2 secondary causes of hyperlipidemia?

A

obesity
uncontrolled diabetes mellitus

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10
Q

measures the amount of hemoglobin that is attached to glucose

A

A1c

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11
Q

how is A1c damaged by high glucose?

A

high glucose damages hemoglobin

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12
Q

at what ages should men and women with low cardiovascular risk be screened?

A

males over 35
females over 45

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13
Q

at what ages should men and women with high cardiovascular risk be screened?

A

males 25-30
females 30-35

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14
Q

what 2 measurements should a hyperlipidemia screening include?

A

total cholesterol
HDL

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15
Q

which ratio is the better predictor of CHD risk than LDL cholesterol?

A

non-HDL cholesterol (total cholesterol) to HDL cholesterol

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16
Q

measurement of calcified atherosclerosis with a non-contrast CT scan of the heart

A

coronary artery calcium scoring (CAC)

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17
Q

because statins may cause muscle pain, what should we worry about?

A

rhabdomyolysis

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18
Q

what medication can a patient, use who does not meet cholesterol treatment goals with dietary modification and maximally-tolerated statin therapy?

A

Ezetimibe

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19
Q

what medication is recommended in combination with maximally tolerated statin therapy?

A

Bempedoic acid

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20
Q

fully humanized monoclonal antibodies that bind free plasma PCSK9 that lowers LDL-C levels (PCSK9 inhibitor)

A

Evolocumab
Alirocumab

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21
Q

what is the first step in treating hyperlipidemia?

A

lifestyle changes

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22
Q

what does ASCVD include?

A

coronary heart disease
stroke
peripheral arterial disease

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23
Q

by how much should LDL-C levels be lowered in group 1 patients with ASCVD?

A

at least 50%

24
Q

how much should LDL-C levels be in group 1 patients with multiple ASCVD events or 1 ASCVD event and high-risk conditions?

25
what should we do if a patient cannot hit an LDL of 70 with statins?
add ezetimibe
26
what should we do if a patient cannot hit an LDL of 70 with statins and ezetimibe?
add a PCSK9 inhibitor (evolocumab)
27
what should we do in a group 2 patient with severe primary hypercholesterolemia?
start statin therapy
28
what is the target in a group 2 patient with severe primary hypercholesterolemia?
100
29
in a group 2 patient with severe primary hypercholesterolemia, what should we do if LDL remains over 100 on a statin therapy?
add ezetimibe
30
in a group 2 patient with severe primary hypercholesterolemia, what should we do if LDL remains over 100 on a statin therapy and ezetimibe?
add PCSK9 inhibitor
31
in patients 40-75 years of age with diabetes and an LDL of 70-189, what should we do?
high-intensity statin
32
in patients 40-75 years of age with diabetes and an LDL of 70-189, what is the target?
decrease LDL by at least 50%
33
in patients 40-75 years with LCL 70-189 and an estimated 10 year ASCVD risk over 7.5%, what should we do?
start a moderate-intensity statin
34
in patients 40-75 years with LCL 70-189 and an estimated 10 year ASCVD risk 7.5-19.9%, what is the target?
decrease LDL by at least 30%
35
in patients 40-75 years with LCL 70-189 and an estimated 10 year ASCVD risk over 20%, what is the target?
decrease LDL by at least 50%
36
in patients 40-75 with LDC 70-189 and an estimated 10 year ASCVD risk of over 7.5% and who do not want to start statins, what should we consider?
coronary artery calcium study
37
what CAC score is wanted?
zero
38
what scores favor statin therapy, especially in those over 55 years of age?
1-99
39
what scores is statin therapy indicated, unless there are extenuating circumstances?
100 or above
40
when should lipid measurements take place after statin initiation or dose adjustment?
4-12 weeks (1-3 months)
41
how often should lipid measurements be repeated when managing hyperlipidemia?
every 3-12 months as needed
42
what are 4 side effects that patients may experience when taking a statin?
1. pain/tenderness 2. stiffness 3. cramping 4. weakness/fatigue
43
what should I do if a patient on a statin presents with unexplained severe muscle symptoms and fatigue? (2)
1. DC statin 2. work up for rhabdomyolysis
44
what does a work up for rhabdomyolysis include? (3)
CK creatinine UA for myoglobinuria
45
what does myoglobinuria look like?
coca cola urine
46
what should I do for a patient that presents with mild to moderate muscle symptoms on a statin?
1. take a vacation from statin 2. restart statin if symptoms resolve and no contraindications exist (same or lower dose)
47
what should I do for a patient that presents with mild to moderate muscle symptoms on a statin and a relationship between the two exists? (3)
1. DC statin 2. let symptoms resolve 3. start different statin on low dose with gradual increase
48
what should I do for a patient over 75 years who does not have a history of heart attacks or ASCVD, but experiences muscle symptoms?
remove statin
49
what should I do for a patient who presents with mild to moderate muscle symptoms that continue after 2 months of no statin treatment and CK levels do not resolve?
search for secondary cause
50
elevated TG associated with cardiovascular disease
hypertriglyceridemia
51
what level of triglycerides is a risk factor for pancreatitis?
near or above 100
52
how do most levels of triglycerides improve?
lifestyle changes
53
what do very high levels of triglycerides require?
drug therapy
54
what can lower TG levels as much as 50%?
fish oil
55
what is the bad news about high cholesterol and metabolic syndrome?
asymptomatic

Cardiology (19 decks)

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