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Clin Med II MHM - Cardio 1 > Hyperlipidemia > Flashcards

Hyperlipidemia Flashcards

1
Q

Sources of cholesterol

A
  • Liver production (75-80%)

- Dietary

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2
Q

Dyslipidemia definition

A
  • High cholesterol
  • High TG
  • High cholesterol & TG
  • High LDL
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3
Q

Chylomicron

A

Lipoprotein (containing digested fats) formed and absorbed in small intestine

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4
Q

Types of triglycerides

A
  • Saturated (meat, dairy, some veggies, exotic oils)
  • Monounsaturated (olive/canola oil, peanuts, avocados)
  • Polyunsaturated (essential fats, sunflower/soybean oil, cold water fish)
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5
Q

Which triglycerides have the greatest impact on increasing LDL?

A

Saturated

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6
Q

The higher density of lipoprotein means ____ lipid content

A

Lower

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7
Q

Function of HDL

A
  • Transports cholesterol back to liver

- There it is used to make bile salts OR excreted

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8
Q

Cholesterol is a critical component of:

A
  • Cell membranes

- Bile

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9
Q

Cholesterol is a precursor of:

A

Steroid hormones

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10
Q

Lipoprotein =

A

Apoprotein + lipid

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11
Q

Apoproteins

A

Transport cholesterol

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12
Q

What is the rate limiting step in the synthesis of cholesterol?

A

HMG CoA reductase

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13
Q

Primary hyperlipidemia

A
  • Single or multiple genetic mutations

- Results in overproduction or defective clearance

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14
Q

Types of primary hyperlipidemia

A
  1. Familial hypercholesterol (Type IIa, increased LDL)
  2. Familial combined (increased LDL and VLDL)
  3. Familial hyperTG (increased TG, autosomal dominant)
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15
Q

Which type of primary hyperlipidemia has the highest risk for pancreatitis?

A

Familial hypertriglyceridemia

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16
Q

Type IIa familial hypercholesterolemia - lab findings, clinical features, therapy

A
  • TG normal, LDL high, chol high
  • Onset at all ages
  • Premature vascular disease
  • Xanthomas
  • Tx = low fat/chol diet, meds, intestinal bypass
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17
Q

Secondary hyperlipidemia

A
  • Sedentary lifestyle
  • Excessive intake of bad fats and cholesterol
  • DM or metabolic syndrome
  • ETOH, tobacco
  • CKD, hypothyroid, liver disease
  • Meds
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18
Q

Pathophys of atherosclerosis

A
  • Cholesterol deposits in vascular walls
  • Fatty streaks become fibrous plaques
  • Inflammation causes plaque instability leading to rupture
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19
Q

Lipidemia retinalis

A

Cream colored blood vessels in the fundus (TG > 2000 mg/dL)

20
Q

Definition of metabolic syndrome

A
  • Cluster of common conditions that increases T2DM and CVD risk
  • 3 criteria (abdominal obesity, impaired gluc tolerance, decreased HDL, increased TG, HTN)
21
Q

Framingham risk score

A

Used to determine CVD risk in asymptomatic patients within 10 years

22
Q

ATP III guidelines for hyperlipidemia screening

A

Adults over 20 yo every 5 years

23
Q

Desirable serum total cholesterol

A
24
Q

Optimal serum LDL

A
25
Q

LDL goal for drug therapy

A

30-40% reduction in LDL

60% reduction in LDL is ideal

26
Q

Optimal serum TG

A
27
Q

Optimal serum HDL

A

60+ mg/dL

28
Q

Elevated HDL is a negative risk factor. Explain what that means

A

It removes one risk factor from the total count

29
Q

For every 1% decrease in serum cholesterol, CVD risk is ____

A

Decreased by 2%

30
Q

T/F: Dietary intake of saturated fat has much more of an influence on serum cholesterol levels than dietary cholesterol intake.

A

TRUE

31
Q

Total dietary fat intake should be ____% of total calories

A

20-35%

32
Q

When is bariatric surgery considered?

A

BMI 40+ or 35+ with comorbidities

33
Q

Define glycemic index

A

A measure of the rate of the rise in serum glucose from various food sources

34
Q

Consider high dose statin if 10 yr risk by new calculator is:

A

7.5%+

35
Q

Dyslipidemia treatment goals for those without comorbidities and with T2DM/CVD?

A

-LDL

36
Q

Treatment options for lowering LDL

A
  1. Lifestyle mods

2. Meds (4 classes - statins, bile acid sequestrants, fibric acids, nicotinic acids)

37
Q

What are statins used for?

A

Both primary and secondary prevention

38
Q

What are the only lipid lowering agents considered safe in pregnancy?

A

Bile acid sequestrants

39
Q

Side effects of fibric acid derivatives?

A
  • Cholelithiasis
  • Hepatitis
  • Myositis
40
Q

What should you advise a patient to do if omega 3 pills are causing GERD?

A

Place capsules in freezer

41
Q

Which statin is the only one not metabolized by CYP450?

A

Pravastatin

42
Q

Which drug classes lower LDL?

A
  • Bile acid sequestrants
  • Nicotinic acids
  • Fibrates
43
Q

Which drug classes lower TGs?

A
  • Fibrates
  • Nicotinic acids
  • Omega 3
44
Q

Which drug classes enhance HDL?

A
  • Statins
  • Fibrates
  • Bile acid sequestrants
  • Nicotinic acids
45
Q

Side effects of PCSK9 inhibitors

A

Neurocognitive events reported during trials

Clin Med II MHM - Cardio 1 (7 decks)

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