Hyperlipidemia: Lecture 1 Flashcards

1
Q

Normal Cholesterol Homeostasis

A

Dietary cholesterol goes from GI tract and brought to liver by Chylomicrons

Get packaged into VLDL, and travels through blood stream to other tissues. Along the way it gets turned into LDL due to muscles and organs taking TG.

LDL taken up into cells, and then excess cholesterol is put into HDL and sent back to liver in process called Reverse Cholesterol Transport

Cholesterol used to make bile to break down fats

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2
Q

Role of Lipoproteins

A

transport TGs and Cholesterol from liver to tissues and back

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3
Q

Chylomicrons have…

A

lowest density but must TGs

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4
Q

TG/Chol/Protein of Chylomicrons

A

90/5/5

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5
Q

TG/Chol/Protein VLDL

A

60/30/10

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6
Q

TG/Chol/Protein LDL

A

10/60/30

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7
Q

TG/Chol/Protein HDL

A

10/30/60

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8
Q

What APO protein thought to play role in Anti-Atherosclerotic properties of HDL?

A

APO A-1

Found on HDL

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9
Q

Which APO protein is thought to be Atherogenic

A

APO B

Found on Chylomicrons, VLDL, LDL

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10
Q

General CV Risk Factors

A
Hypertension
Hyperlipidemia
Diabetes
Smoking
Obesity
Physical Inactivity
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11
Q

Examples of ASCVD/CHD/CAD

A
MI
ACS
Stable/Unstable Angina
CVA (stroke) or TIA
CABG
PTCA
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12
Q

ASCVD more prevalent in….

A

nonhispanic black males and females

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13
Q

average life loss to patient after having Heart attack?

A

11.5 years

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14
Q

How does too much Cholesterol leads to ASCVD

A

Too much cholesterol start to deposit between layers of artery walls, forming fatty streak.

Body sends macrophages, ingest cholesterol but they turn into foam cells.

This causes fatty streak to become bigger and form into plaque. Body then forms a fibrous cap which is thin nd not very strong.

When cap breaks, a blood clot forms and blocks the artery. Depending where artery is, determines what kind of ASCVD event occurs.

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15
Q

Size of LDL effect on ASCVD

A

Small dense = more likely to cause ASCVD

Larger, less dense = less likely to cause ASCVD

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16
Q

Effect of decreasing LDL, increasing HDL on ASCVD risk?

A

1% decrease risk for every 1mg/dL LDL decrease

2% decrease risk for every 1mg/dL HDL increase

17
Q

Alcohol effect on Lipids

A

Increase TG

18
Q

Thiazide Diuretics effect on Lipids

A

Increase LDL and TC

19
Q

B Blocker effect on Lipids

A

Increase TG, decrease HDL

20
Q

Glucocorticoids effect on Lipids

A

Increase VLDL,LDL, TC

21
Q

Olanzapine effect on lipids

A

Increase LDL, TC

22
Q

Bile acid specific DI

A

Don’t take drugs 2hrs before or 4hrs after taking them

23
Q

Diet changes for Hyperlipidemia

A

Eat: Veggies, Fruits, Whole Grains, Low-fat Dairy, Poultry/fish, nuts, nontropical veg oil

Limit: Sweet, Sugar sweetened Bev, red meats

24
Q

Herbal/OTC products that might have some efficacy on Cholesterol

A

Fish Oil
Soy
Cholestin (Red Yeast)
Plant Stanols

25
Q

Good fatty acid

A

Omega -3

flaxseed, Canola, Soybean oil
Oily fish, Fish oil capsules

26
Q

Bad fatty acid

A

Omega 6

Corn, safflower, sunflower oil

27
Q

Omega-3 Recommended intake

A

w/o ASCVD = fish 2/week, use good oils
w/ ASCVD = ~1g EPA/DHA per day
Need to lower TG = 2-4g EPA/DHA per day

28
Q

Lovasa

A

decrease TG synthesis in liver (inhibit acylCOA)

Decrease TG, Increase HDL, and LDL

Increases the large/fluffy LDL, so not as bad

Well tolerated