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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

24
Q

Optimal serum LDL

25
LDL goal for drug therapy
30-40% reduction in LDL | 60% reduction in LDL is ideal
26
Optimal serum TG
27
Optimal serum HDL
60+ mg/dL
28
Elevated HDL is a negative risk factor. Explain what that means
It removes one risk factor from the total count
29
For every 1% decrease in serum cholesterol, CVD risk is ____
Decreased by 2%
30
T/F: Dietary intake of saturated fat has much more of an influence on serum cholesterol levels than dietary cholesterol intake.
TRUE
31
Total dietary fat intake should be ____% of total calories
20-35%
32
When is bariatric surgery considered?
BMI 40+ or 35+ with comorbidities
33
Define glycemic index
A measure of the rate of the rise in serum glucose from various food sources
34
Consider high dose statin if 10 yr risk by new calculator is:
7.5%+
35
Dyslipidemia treatment goals for those without comorbidities and with T2DM/CVD?
-LDL
36
Treatment options for lowering LDL
1. Lifestyle mods | 2. Meds (4 classes - statins, bile acid sequestrants, fibric acids, nicotinic acids)
37
What are statins used for?
Both primary and secondary prevention
38
What are the only lipid lowering agents considered safe in pregnancy?
Bile acid sequestrants
39
Side effects of fibric acid derivatives?
- Cholelithiasis - Hepatitis - Myositis
40
What should you advise a patient to do if omega 3 pills are causing GERD?
Place capsules in freezer
41
Which statin is the only one not metabolized by CYP450?
Pravastatin
42
Which drug classes lower LDL?
- Bile acid sequestrants - Nicotinic acids - Fibrates
43
Which drug classes lower TGs?
- Fibrates - Nicotinic acids - Omega 3
44
Which drug classes enhance HDL?
- Statins - Fibrates - Bile acid sequestrants - Nicotinic acids
45
Side effects of PCSK9 inhibitors
Neurocognitive events reported during trials

Clin Med II MHM - Cardio 1 (7 decks)

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