Lipidology Flashcards
Type I (Chylomicrons)
Contain TGAs
Defect dec’d familial LPL, CII
Skin lesions: eruptive xanthomas
Type II (LDL)
Contains: LDL
Defect - dec’d LDL rct’s
Skin lesions: Tendon, xanthomas
Type III (IDL)
Contains: LDL+TGAs
Defect Abnormal APoE
Skin lesions: Palmar/Tuberous Xanthomas
Type IV (VLDL)
Contains: TGAs
Defect dec’d familial LPL, CII
Skin Lesions: Eruptive Xanthomas
Type V (VLDL+Chylomicrons)
Contains: TGAs
Defect dec’d familial LPL, CII
Skin Lesions: Eruptive Xanthomas
Statins
Primary LDL tx, dec’s LDL, inc’s TGA, inc’d HDL
S/E - inc’d LFTs, CPK, wt gain
Glucose intolerance
Fibric Acid derivatives
Primary TGA tx
Inc’d /N LDL, dec’d TGA, inc’d HDL
S/E Gallstone, hepatoma
Bile Acid derivatives
Secondary LDL tx
dec’d LDL, TGAs, inc’d HDL
S/E Bloating, constipation, nausea
Nicotinic Acid
Primary HDL, secondary LDL
dec’d LDL, very dec’d TGA, very inc’d HDL
S/E Abd pain, nausesa, flushing, dry skin
Ezetimibe
TGA tx, seconary LDL
dec’d LDL, dec’d TGA
Apo protien E def
Type III
Def of LDL rct’s
Type IIa
Tendon xanthomas
Type IIa
Pancreatitis
Type I, IV, V
Pt with LDL 140, TGA 600 -0 fhx hypertriglyceridemia
Fibrinc acid derivative (gemfibrozil, fenofibrate)
Which reduces TG of 500 in pt with BMI 30
Losing wegith 5-10%
Defect - C II def - eruptive xanthoma
Tx: Gemfibrozil
Palmar Xanthoma
Most likely defect Apo E
Chol guidelines
No CAD, 0-1 risk factor LDL <130
CAD equivalent risk factors
DM, Vascular dz, multiple risk factors with 10 year framingham >20%
Treatment
First line = diet Goo fats, < 200mg chol 15% calories from protienes excercise 1hr/day, 5 days/ week smoking cessagion
Reynolds vs Framingham
Reyolds include high sensitivety CRP
Parental h/o MI
Accounts for gender…
Pt wants alternative med for prevention of CAD
Omega 3 fatty acid
40yo no risk factors for CAD with LDL 175
first diet/excercise
Pt with DM likely has…
inc’d LDL, inc’d TGA, dec’d HDL
