Lipids Flashcards
0
Q
Ankle/brachial ratio
A
- ratio > 1: normal
- ratio < 1: ischemia (.5 is severe ischemia)
1
Q
Intermittent claudication Dx and other symptoms
A
Classic presenting symptom of PAD
- 10% of PTs present this way
- decreased distal pulses, bruits, hair loss, cyanosis/pallor
2
Q
ABI .78
A
~ 30% risk if MI w/in 5 years, ischemic stroke or vascular death
3
Q
Most effective treatment for PAD
A
- exercise
- to point of maximal pain
4
Q
Drug therapy for PAD
A
- vasodilators
- ASA
- ASA + dipyrimidole
- hypolipidemic agents
- cilostazol
- clopedigrel (plavix)
5
Q
Indications for surgery (2)
A
Incapacitating/resting pain
6
Q
Calculating LDL
A
LDL = Total chol-HDL-trigs
* when trigs < 400
7
Q
Statins
A
- HMG CoA reductase inhib
- lower LdL, raise HDL, lower trigs
- rosuvostatin (Crestor) super-statin (50%+redux)
- caution in asians (myopathies)
- rhabdo, myalgias, elevated CPK, hepatotoxicity
- CYP3A4: effected by CYP altering drugs
8
Q
Statin contraindications (relative)
A
- cyclosporine
- gemfibrozil
- niacin
- erythromycin
- Azoles
9
Q
Absolute statin Cind
A
- pregnancy/lactation
- liver disease
- elevated ALTs
10
Q
Binding resins
A
- cholestyramine, colestipol, colesevelam
- interrupt interohepatic recirc
- lowers LDL
- can raise trigs (pancreatitis tg > 300)
- constipation, pain to take (powder), redux vits ADEK
11
Q
Niacin
A
- MOA: unknown
- raises HDL, lowers LDL
- GI issues, flushing, glucose dysregulation, blurred vision,
- rare: exaserbation of peptic ulcer disease and hepatotoxicity
12
Q
Fibrates
A
- increase LPL
- gemfibrozil, fenofibrate
- not with statins!!
- bile stones
- increase effects of oral hypoglycemics and warfarin
13
Q
Ezetimibe
A
- inhibits chol absorption
- acts on BBmvilli enzymes
- only seems to effect H/LDL not trigs
- don’t use in kids or pregnant/nursing
- potentially no benefit: may increase atherosclerotic plaques
14
Q
Fish oil
A
- potential effect on LDL
- inhibits platelet aggregation
