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EOR Family med > hyperlipidemia etc > Flashcards

hyperlipidemia etc Flashcards

1
Q

causes of hypercholesterolemia

A

hypothyroidism
pregnancy
kidney failure

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2
Q

cause of hypertriglyceridemia

A

DM
ETOH
obesity
steroids
estrogen

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3
Q

where do people commonly develop xanthomas

A

eyelids
Achilles tendon

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4
Q

what portion of people with xanthomas have normal lipid levels

A

2/3

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5
Q

hypertriglyceridemia can cause

A

pancreatitis

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6
Q

LDL goals for patients with CAD or equivalent

A

start drugs at > 130
LDL goal: < 100
optimal < 70

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7
Q

LDL goals for pts w no CAD but > 2 RF

A

start drugs at > 160
LDL goal < 130

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8
Q

LDL goals for everyone else (No CAD or equivalent or 1 or no RF)

A

start drugs at > 190
LDL goal < 160

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9
Q

tx for isolated LDL increase

A

statins
bile acid sequestrants

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10
Q

examples of bile acid sequestrants

A

Colestipal
Cholestyramine
Colesevelam

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11
Q

tx for isolated triglyceride incrase

A

fibrates
niacin (B3)

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12
Q

examples of fibrates

A

Fenofibrate
Fenofibric acid
Gemfibrozil
Clofibrate (not available in US)

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13
Q

tx to increase HDL

A

fibrates
niacin

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14
Q

tx for T2DM with hyperlipidemia

A

fibrates
statins
niacin may cause hyperglycemia so need to caution

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15
Q

what are the best class of meds to decrease LDL

A

statins

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16
Q

ADE statins

A

myositis
myalgias
rhabdo
hepatitis

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17
Q

contraindication statins

A

pregnancy
breast feeding
antibiotics and tetracyclines increase blood levels of statins

18
Q

when is it best to take a statin

A

at bed time (when cholesterol synthesis is maximal)

19
Q

what is the best drug to increase HDL

A

niacin/nicotonic acids (B3)

20
Q

ADE niacin/nicotinic acids

A

flushing
headache
warm sensation
pruritus
hyperuricemia (may precipitate gout)

21
Q

what can be taken prior to niacin to decrease flushing

A

Ibuprofen or aspirin

22
Q

what is the best drug to decrease triglycerides

23
Q

ADE fibrates

A

increased LFTs
myositis
myalgias (esp w concomitant statin use)
increase bile acid lithogenicity (gallstones)

24
Q

contraindications to fibrates

A

severe hepatobiliary disease
renal disease

25
what do bile acid sequestrants do to HDL, LDL, triglycerides
decreased LDL (increased w statins) increase HDL may increase TG (use in patients w normal TG)
26
what is the only hyperlipidemia drug that is safe to use in pregnancy
bile acid sequestrants
27
what else can bile acid sequestrants be used for
pruritus associated w biliary obstruction
28
ADE bile acid sequestrants
N/V bloating crampy abdominal pain increased LFTs increased TG may impair absorption of digoxin, warfarin, fat soluble vitamins
29
what will you see on fundoycopic exam in advanced stage malignant HTN
papilledema
30
screening for hyperlipidemia
universal screening - once btwn 9 and 11 and again btwn 17 and 21 high risk - follow up 25-30 years or men and 30-35 years for women low risk - follow up 35 men and 45 women
31
what things make someone "high risk" for hyperlipidemia
HTN DM cigarette use
32
what triglyceride levels are associated w pancreatitis
> 1000 mg/dL
33
who should receive a high intensity statin
anyone with LDL levels >/= 190 those with an estimated 10-year atherosclerotic cvd risk >/= 20%
34
who should receive a moderate intensity statin
pts w DM between 45-75 years and LDL of 70-189 those without DM and estimated 10-year atherosclerotic CVD risk > 7.5% but less than 20%
35
high intensity statin regimens aim to reduce LDL by
>/= 50%
36
moderate intensity statin regimens aim to reduce LDL by
30-50%
37
high intensity statin therapy options
atorvastatin 40-80 mg rosuvastatin 20-40 mg
38
moderate intensity statin therapy options
atorvastatin 10-20 mg rosuvastatin 5-10 mg simvastatin 20-40 mg pravastatin 40-80 mg
39
at what triglyceride level should patients receive tx for hypertriglyceridemia
> 500
40
metabolic syndrome
three or more waist circumference greater than 102 cm in men or greater than 88 cm in women triglyceride level greater than 150 HDL less than 40 in men and 50 in women systolic BP greater than 130 or diastolic greater than 85 fasting plasma glucose level greater than 100 being on medical therapy for any also meets criteria
41
recommended cholesterol parameters
Total < 200 LDL < 100 HDL > 60 TG < 150

EOR Family med (25 decks)

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