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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

A

fibrates

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
Q

what do bile acid sequestrants do to HDL, LDL, triglycerides

A

decreased LDL (increased w statins)
increase HDL
may increase TG (use in patients w normal TG)

26
Q

what is the only hyperlipidemia drug that is safe to use in pregnancy

A

bile acid sequestrants

27
Q

what else can bile acid sequestrants be used for

A

pruritus associated w biliary obstruction

28
Q

ADE bile acid sequestrants

A

N/V
bloating
crampy abdominal pain
increased LFTs
increased TG
may impair absorption of digoxin, warfarin, fat soluble vitamins

29
Q

what will you see on fundoycopic exam in advanced stage malignant HTN

A

papilledema

30
Q

screening for hyperlipidemia

A

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
Q

what things make someone “high risk” for hyperlipidemia

A

HTN
DM
cigarette use

32
Q

what triglyceride levels are associated w pancreatitis

A

> 1000 mg/dL

33
Q

who should receive a high intensity statin

A

anyone with LDL levels >/= 190
those with an estimated 10-year atherosclerotic cvd risk >/= 20%

34
Q

who should receive a moderate intensity statin

A

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
Q

high intensity statin regimens aim to reduce LDL by

A

> /= 50%

36
Q

moderate intensity statin regimens aim to reduce LDL by

A

30-50%

37
Q

high intensity statin therapy options

A

atorvastatin 40-80 mg
rosuvastatin 20-40 mg

38
Q

moderate intensity statin therapy options

A

atorvastatin 10-20 mg
rosuvastatin 5-10 mg
simvastatin 20-40 mg
pravastatin 40-80 mg

39
Q

at what triglyceride level should patients receive tx for hypertriglyceridemia

A

> 500

40
Q

metabolic syndrome

A

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
Q

recommended cholesterol parameters

A

Total < 200
LDL < 100
HDL > 60
TG < 150

EOR Family med (25 decks)

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