Hyperlipidemia

Question 1

lipoproteins

Answer 1

plasma proteins that transport cholesterol, TG, etc

Question 2

hyperlipidemia

Answer 2

elevated lipids in blood, major of atherosclerosis

Question 3

dyslipidemis

Answer 3

disorder of lipoprotein metabolism

Question 4

LDL and VDL

Answer 4

promote atherosclerosis

Question 5

HDL

Answer 5

inhibits atherosclerosis

Question 6

TG

Answer 6

major source of fat, sever elevations–> PANCREATITIS

Question 7

2CD hyperlipidemia

Answer 7

DM, EtOH use, hypothyroidism, hypercortisolims, acromegal, obesity, sedentary lifestyle, renal/liver, estrogens, thiazide diuretics, BB

Question 8

common clinical signs? think skin

Answer 8

eruptive and tendinous xanthomas; xanthelasmas (xanthoma on eye)

Question 9

arcus senilis?

Answer 9

deposition of lipid in the peripheral corneal stroma. It starts at the inferior and superior poles of the cornea and in the late stages encircles the entire circumference

Question 10

lipemia retinalis

Answer 10

lipid depostis in retinal arteries (fundoscopy)

Question 11

when do you start to screen?

Answer 11

if RF, immediately, if not, males at 35, females at 45

Question 12

tx if high LDL and risk of CAD?

Answer 12

daily ASA

Question 13

niacin adr?

Answer 13

flushing

Question 14

fibric acid?

Answer 14

gemifibrozil, fenofibrate (Tricor)

ADR: cholelithiasis, hepatitis, myositis

Question 15

ezetimibe

Answer 15

blocks intestinal absroption of dietary and biliary cholesterol at brush border

Question 16

Framingham Heart Study

Answer 16

risk for MI increases by about 25% for every 5 mg/dL decrement below the median values for men and women

Question 17

what drugs an decrease HDL?

Answer 17

BB, progesterone, anabolic steroids

Question 18

what drugs and good causes high TG?

Answer 18

corticosteroids, estrogens, BB, retinoids; high carb diet (>60%)

Question 19

metabolic syndrome criteria

Answer 19

3 of the following:
1) abdominal obesity
Men- >40 inch
women> 35 inch
2) TG >150
3)HDL
M <40
W<50
4) BP >130/85
5)FBG >110

Question 20

impact on vasculature- HTN

Answer 20

vhr: cerebral, renal
hr: carotid

Question 21

DM vasculature risk

Answer 21

coronary

carotid, renal, peripheral

Question 22

smoking

Answer 22

peripheral

cerebral, caroltic, coronary, renal

Question 23

dyslipidemia

Answer 23

carotid, coronary

Question 24

UPSTF screening

Answer 24

• Males @ increased risk for CHD  screen at 20 years
• Males @ no increased risk for CHD: screen at 35 and older
• Females @ increased risk for CHD: screen at 20
• Females @ no increased risk for CHD: no recommendations for or against screening
• Peds < 20 years : insufficient evidence to recommend screening

Question 25

ATP III guidelines step 1

Answer 25

fasting lipid panel

Question 26

step 2

Answer 26

identify presence of CHD events or risk of CHD (PAD, AAA, CAD, DM)

Question 27

step 3

Answer 27

Major risk factors:

smokine, HTN, Low HDL, family hx of prematrue CHD, Age (M>45, W> 55)

Question 28

step 4

Answer 28

if 2+ risk factors, determin 10 yr risk

Question 29

step 5/step 6

Answer 29

est. lipid goal, begin treating

* *want to lower LDL then work on TG, the HDL

Question 30

tx of low HDL

Answer 30

first reach LDL, then intensify weight management and increase physical activity

Question 31

what is the first symptom of hyperlipidemia?

Answer 31

none