Lipid disease Flashcards
State 5 causes of secondary hyperlipidaemia
Hypothyroidism Diabetes mellitus (poorly controlled) Obesity CKD Nephrotic syndrome Hepatic dysfunction and cholestasis Anorexia nervosa Drugs: Thiazide diuretics, steroids, B-blockers
What are the types of primary hyperlipidaemia?
Hypertriglyceridaemia (VLDL and chylomicrons)
Hypercholesterolaemia (LDL)
HDL disorders
Combined hyperlipidaemia
Outline the management of hyperlipidaemia
Lipid-lowering diet
Exercise, weight loss, smoking cessation
Hypertriglyceridaemia: Fibrates
Combined: Fibrates
Hypercholesterolaemia: Statin or Ezetimibe
Describe the mechanism of action of statins
Inhibit HMG-CoA reductase to prevent synthesis of cholesterol
Name 3 side effects of statins
Constant ache/muscle stiffness -> creatinine kinase Deranged LFTs Diarrhoea Myopathy Raised serum ciclosporin
When should statins be offered to people with diabetes?
Atorvastatin 20mg daily
Primary prevention for people with 10% or greater 10-year risk of developing CVD, including T2DM and CKD.
Offered to T1DM in people:
- over age 40
- diabetes for over 10 years
- established nephropathy
- other CVD risk factors
Who should be screened for hyperlipidaemia?
FHx of CAD (especially below 50yr) FHx of lipid disorders Presence of xanthoma Presence of xanthelasma or corneal arcus before 40yr Obesity Diabetes mellitus Hypertension Acute pancreatitis Patients undergoing renal replacement therapy
When should statins be taken?
Last thing at night, as this is during peak cholesterol synthesis.
