Hypolipidemic Drugs & Prevention

Question 1

Define premature coronary disease

Answer 1

Men before 50 yo
Women before 60 yo
Atherosclerosis –> UA, STEMI, NSTEMI

Question 2

Xanthoma - what is it? What disease is it indicative of?

Answer 2

Symptom of familial hypercholesterolemia
Deposits of cholesterol ester
Firm, nodular & non-tender
@ vascular lining, hands, elbows, knees, Achilles

Question 3

Labs for familial hypercholesterolemia (type 2a aka heterozygous)

Answer 3

High LDL

High total cholesterol

Question 4

Calculate LDL

Answer 4

TC - HDL - TG/5

But doesn’t work for HIGH TGs - over 400 b/c equation will underestimate of LDL cholesterol

Question 5

Describe familial combined hyperlipidemia (type 2b)

Answer 5

↑VLDL –> ↑TG & LDL

B/c defective LDL receptor

Question 6

Describe dysbeta-lipo-proteinemia (type 3)

Answer 6

↓apoE remnant breakdown –> ↑cholesterol & TGs
Symptoms
- Yellow palm streaking
- Xanthomas

Question 7

Describe familial hypertriglyceridemia (type 4)

Answer 7

↑TG b/c abnormal breakdown
↓HDL
LDL normal or low

Question 8

Describe familial hypo-alpha-lipo-proteinemia

Answer 8

↓HDL
↑TG
Causes:
- ApoA1 def
- ABCA 1 def = Tangiers disease
- LCAT def

Question 9

Treat familial hypercholesterolemia

Answer 9

Statins

Maybe + cholesterol absorption inhibitor if don’t drop enough

Question 10

Do you give statins to pregnant women?

Answer 10

NO teratogenic

Question 11

Meds to lower cholesterol in pregnant women

Answer 11

Bile acid resins

Question 12

Recommendations for babies born with familial HL

Answer 12

Fat restriction at early age
Prevent rise in cholesterol
No statins b/c change gonadal steroid development