Lipids Flashcards
Risk Factors for Hyperlipidemia
Men >45 Women>55 Family history of CHD, HTN Current smoker <40 HDL Hypotension DM Known CVD Risk
Extremely high levels of chylomicrons or VLDL particles can cause:
Eruptive Xanthomas
High levels of LDL can cause:
Tendinous Xanthomas
High levels of triglycerides can cause:
Lipemia Retinalis
Extremely high levels of chylomicrons or VLDL particles can cause:
Eruptive Xanthomas
High levels of HDH can cause:
Tendinous Xanthomas
High levels of triglycerides can cause:
Lipemia Retinalis
NCEP recommends screening all individuals for high cholesterol beginning at what age?
20
T/F: Most individuals have no clinical signs of high cholesterol
True. Usually indicated in blood testing.
What values indicate an increase in CHD risk with high cholesterol?
Each 10 mg/dl of total cholesterol increases the risk of CHD by 10%
What constitutes a patient as high risk for CAD?
Hx of: CAD MI Stroke CHD
What constitutes a patient as intermediate risk?
2+ Risk Factors
What constitutes a patient as low risk?
<2 Risk Factors
HDL
Good cholesterol
High Density
LDL
Bad Cholesterol
Low Density
Treatment for Hyperlipidemia
Diet Exercise Weight loss Smoking cessation Aspirin therapy Rx if needed
Benefit of HDL
If HDL>60, it subtracts a risk factor.
Niacin
Lipid-lowering
Causes flushing due to prostaglandins
Intolerance is common
Cholestyramine, Colesevelam, and Colestipol
Bind bile acids
Lowers LDL
GI issues are common
HMG-CoA reductase inhibitors are more commonly referred to as?
Statins
HMG-CoA reductase inhibitors (statins) mechanism
Work by inhibiting the rate-limiting enzyme in the formation of cholesterol
Gemfibrozil
Fibrate (PPAR-alpha) agonists):
Lowers LDL and HDL
Reduces CHD
Ezetimibe
Inhibits cholesterol transporter
Lowers LDL
inhibits cholesterol absorption in the small bowel
Side Effects of Statins (HMG-CoA Reductase Inhibitors
Muscle aches
Mild GI issues
Liver toxicity
Side Effects of Gemfibrozil
Gall Stones
Hepatitis
Muscle Inflammation
Calculating Total Cholesterol
HDL + LDL + VLDL
Where are most Triglycerides located?
VLDL
The liver is the power house producer of?
Lipoproteins
What can cause increases in Triglycerides?
- Alcohol
- DM
- Pregnancy
- Hypothyroidism (Decreases LPL)
- Nephrotic Syndrome (decreases TG clearance)
What is the best predictor for Cardiovascular Risk?
Apo B
What type of cholesterol is most responsive to Lifestyle?
Non-HDLs, which include:
Apo B
LDL-P
What are the names of the most common statins?
Pravastatin
Simvastatin
Atorvastatin
Rosuvastatin
If pt is maxed out on statins, what meds can you use?
Ezetimibe: Inhibits Cholesterol Absorption in Small Bowel, reducing LDL
Nicotinic Acid: Raises HDL, reduces coronary events
Fenofibrate: Work on nuclear receptor dominant=
Side Effects of Nicotinic Acid
Flushing Itching Worsens Insulin Resistance Increases Uric Acid Peptic Ulcers
