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Cardiology > Lipid Disorders > Flashcards

Lipid Disorders Flashcards

1
Q

In healthy endothelium, what two factors cause vasodilation?

A

Nitric oxide
Prostacyclin

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2
Q

In patient’s with known cardiovascular disease, lowering what leads to a consistent reduction in total mortality and recurrent CV events?

A

cholesterol

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3
Q

Risk of ischemic heart disease increases with higher levels of what?

A

total serum cholesterol levels

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4
Q

Elevated what is correlated with increased incidence of CAD and
atherosclerosis?

A

LDL

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5
Q

What condition promotes retention of lipoproteins in the intima and
can accelerate the process of atherosclerosis?

A

Hypertension

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6
Q

What percentage of DM patients succumb to atherosclerosis-related events?

A

80%

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7
Q

What benefits do exercise have in relation to the endothelium?

A

Raises HDL

Secretes NO, prostacyclines

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8
Q

What level of triglycerides up the patient at risk for pancreatitis?

A

Triglycerides >500

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9
Q

What hormone is protective by increasing HDL and decreasing LDL?

A

Estrogen

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10
Q

What disease correlates with levels of plasma cholesterol and/or
tri-acylglycerol-containing lipoprotein particles 🡪 hyperlipidemias 🡪
atherogenesis

A

Coronary Artery Disease

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11
Q

List some risk factors for coronary artery disease

A

Advanced age
Male gender
Heredity
Lack of physical exercise
Dyslipidemia
Tobacco smoking
HTN
DM
Metabolic syndrome
Estrogen status (post-menopausal)
HDL <35mg/dL

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12
Q

You should start screening for hyperlipidemia in patients at age 20 if they have the following:

A

Smoker

Have diabetes

Heart disease runs in the family

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13
Q

What are the lifestyle modifications for hyperlipidemia?

A

Diet
Smoking cessation
Exercise
Weight management
Control HTN
Glucose management
Raise HDL

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14
Q

What is the best way to raise HDL?

A

Exercise

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15
Q

What are the DOC for hyperlipidemia?

A

Statins

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16
Q

What are ways to raise HDL?

A

Regular exercise
Weight reduction
Modest alcohol consumption

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17
Q

What are some factors influencing serum lipids?

A

Certain drugs

Uncontrolled DM

Alcohol (Triglycerides)

hypothyroidism

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18
Q

Plaques in blood vessel walls

A

Atheromas

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19
Q

Plaques or nodules composed of lipid-laden histocytes in the skin,
especially the eyelids (xanthelasma)

A

Eruptive xanthomas

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20
Q

Eruptive xanthomas are an indication of high levels of which lipid?

A

triglycerides

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21
Q

Eruptive xanthomas in the eyelids is called what?

A

xanthelasma

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22
Q

Lipid deposits in tendons

A

Tendinous xanthamos

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23
Q

Tendinous xanthamos commonly are deposited in which tendon?

A

Achilles

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24
Q

Tendinous xanthamos are an indication of high levels of which lipid?

A

LDL

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25
Q

Lipid deposits in the cornea are called what?

A

Corneal arcus

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26
Q

Cream-colored blood vessels in the fundus

A

Lipidemia retinalis

27
Q

Lipidemia retinalis is indicative of extremely high levels of what lipid level?

A

Extremely high triglycerides

28
Q

A genetic disorder that results in severe elevations of blood cholesterol levels and an increased risk of early cardiovascular disease

Autosomal dominant

A

Familial Hypercholesterolemia

29
Q

This disease is caused by mutations that impair the body’s ability to
remove LDL cholesterol from the blood

A

Familial Hypercholesterolemia

30
Q

Risk of premature coronary heart disease is elevated by about how much in untreated patients with Familial Hypercholesterolemia?

A

20-fold

31
Q

Screen children with a family history of early CVD of dyslipidemia between what ages?

A

ages 2 and 8

32
Q

A common genetic disorder

Autosomal dominant

Causes a higher than normal level of triglycerides

A

Hypertriglyceridemia

33
Q

Alcohol and estrogen use can make this condition worse

A

Hypertriglyceridemia

34
Q

What other factors are often present in patient’s with hypertriglyceridemia?

A

Obesity, hyperglycemia, and high levels of insulin

35
Q

What factors/modifications can help improve the outcome in patients with hypertriglyceridemia?

A

Losing weight
Keeping diabetes under control

36
Q

What is a complication of excessive TG >500?

A

Pancreatitis

37
Q

“hardening” of the arteries

Chronic inflammatory process of large arteries involving lipids, thrombosis, elements of vascular wall, and immune cells

A

Atherosclerosis

38
Q

Leading cause of mortality and morbidity – number one killer in US and worldwide

A

Atherosclerosis

39
Q

What are the major manifestations of atherosclerosis??

A

cardiovascular disease and stroke

40
Q

What medications have become indispensable in the treatment of CAD?

A

Statins

41
Q

All cells require cholesterol to form membranes and maintain fluidity
of phospholipid bilayer, and we need a minimum of what level to function properly?

A

minimum of 120mg/dL

42
Q

Cholesterol that drops below 120mg/dL is associated with what disorders?

A

cancers and psychiatric disorders

43
Q

What portion of the arterial wall is described below?

Outermost layer

Contains nerves, lymphatics, and blood vessels that nourish cells of the arterial walls

A

Adventitia

44
Q

What portion of the arterial wall is described below?

Middle layer

Thickest layer

Internal and external elastic laminae

Smooth muscle cells and extracellular matrix

A

Medial

45
Q

What portion of the arterial wall is described below?

Inner layer

Closest to arterial lumen

Single layer of endothelial cells

Metabolically active barrier between circulating blood and vessel wall

There is where the damage occurs

A

Intima

46
Q

Maintains homeostasis of vessel wall

Forms a barrier that contains blood within the lumen and limits passage of large molecules from circulation into subendothelial space (example: proteins)

Produces antithrombotic molecules which prevent clotting (can also produce prothrombotic molecules)

Secrete substances that modulate contraction of smooth muscle

Regulate immune response

A

Endothelial Cells

47
Q

Under normal conditions what protects against development of
atherosclerosis?

A

Endothelium

48
Q

When damaged, plays a significant major role in the development of
atherosclerosis

A

Endothelium

49
Q

Earliest visible lesions of atherosclerosis

Yellow discoloration on artery’s inner surface

A

Fatty streak

50
Q

Which type of fibrous cap is described below:

Tend to be more fragile and more likely to rupture

Less obstructive by angiography

A

Thinner cap: vulnerable plaque

51
Q

Which type of fibrous cap is described below:

Causes pronounced arterial narrowing

Have less propensity to rupture

A

Thick cap: stable plaque

52
Q

Areas of your body where you can have complications from
atherosclerosis:

A

CNS – stroke
Kidneys - Renal artery disease
Heart – coronary artery disease
Peripheral artery disease
Aneurysms

53
Q

Common manifestations of atherosclerosis include:

A

Angina pectoris
Myocardial infarction
Stroke
Peripheral arterial disease

54
Q

List some modifiable risk factors for atherosclerosis

A

90%
Dyslipidemia
Tobacco smoking
Hypertension
Diabetes
Metabolic syndrome
Lack of physical exercise

55
Q

List some non-modifiable risk factors for atherosclerosis

A

10%
Advanced age
Male gender
heredity

56
Q

Elevated LDL levels correlate with increased incidence of what?

A

atherosclerosis and CAD

57
Q

What are some causes of elevated LDL cholesterol?

A

High-fat diet
Abnormalities in LDL-receptor clearance mechanism
Genetic defects – familial hyperchoesterolemia

58
Q

Coronary risk ____ as high with total cholesterol level 240mg/dL compared to 200 mg/dL

A

twice

59
Q

This risk factor promotes retention of lipoproteins in the intima by accentuating the production of LDL-binding proteoglycans by smooth muscle cells

A

Hypertension

60
Q

What percentage of diabetics succumb to atherosclerosis-related conditions?

A

80%

61
Q

What disease is considered atherosclerotic risk equivalent, in the same category as people with history of MI?

A

Diabetes

62
Q

Screening in patients without atherosclerotic cardiovascular disease
should start when in men and women?

A

Age 35 in men

Age 45 in women

63
Q

Basic screening for atherosclerosis should include what labs?

A

Total cholesterol
HDL
LDL
Triglycerides
Thyroid function tests
Liver function tests
Fasting glucose
Baseline creatinine kinase
Urine analysis
Consider uric acid level (if think might initiate niacin therapy)

64
Q

Lifestyle modifications in patients with atherosclerosis

A

Diet
Smoking cessation
Controlling HTN
Weight management
Raising HDL levels
Glucose management

Cardiology (13 decks)

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