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CSI Exam 4 > Lipids > Flashcards

Lipids Flashcards

1
Q

A screening lipid panel should be done at ____ years of age per NCEP

A

20

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2
Q

HDL is synthesized in the

A

liver + intestines

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3
Q

VLDL is synthesized in the

A

liver (FFA + cholesterol)

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4
Q

LDL synthesizes

A

bile acid

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5
Q

USPSTF recommends screening Male patients at lower risk should be screened for dyslipidemia at; at higher risk?

A

35; 25

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6
Q

USPSTF recommends screening Female patients at lower risk should be screened for dyslipidemia at; at higher risk?

A

45; 35

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7
Q

Assessment of cholesterol, triglycerides and lipoproteins must be done in a _________

A

in a fasting state

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8
Q

Which values are measured directly on a lipid panel?

A

Total cholesterol, triglycerides and HDL

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9
Q

How do you calculate VLDL using values form a lipid panel?

A

TGs divided by 5 = VLDL

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10
Q

How do you calculate LDL using values form a lipid panel?

A

Total cholesterol - HDL - VLDL = LDL

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11
Q

Why must lipid panels be done in a fasting state?

A

Chylomicrons will confound these measurements (present for <10 after eating)

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12
Q

Recommendations: total cholesterol

A

< 200

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13
Q

Recommendations: LDL

A

< 100

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14
Q

Recommendations: HDL

A

> 40

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15
Q

Recommendations: TGs

A

< 150

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16
Q

Familial Hypercholesterolemia results from

A

mutations in the LDL (apo B/E) receptor

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17
Q

Familial Hypercholesterolemia effects on Lipoproteins

A

decreases the clearance of LDL and increases circulating LDL levels

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18
Q

Familial Hypercholesterolemia will have what Sx

A

Arteries (atheroma), Skin or tendons (xanthoma) Eyelids (xanthelasma), Iris (corneal arcus)

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19
Q

Arteries (atheroma), Skin or tendons (xanthoma) Eyelids (xanthelasma), Iris (corneal arcus) Sx are due to

A

Excess LDL enters macrophages –> foam cell and cholesterol plaque formation

20
Q

Lab Features of Familial Hypercholesterolemia

A

Cholesterol >300 and LDL > 250

21
Q

ATP Guidelines 1-4

A
  1. Cholesterol
  2. CHD or CHD risk factors
  3. Major risk
  4. Risk Calculator
22
Q

Major Risk Factors Include:

A

Smoker, HTN or on Meds, Low HDL (< 40), FMHx of CDH in M < 55 or F < 65, Age of M > 45, F > 55

23
Q

What factor subtracts a risk?

A

High HDL > 60

24
Q

Framingham Risk Score calculates

A

10-yr CHD risk

25
Q

If patient has CHD, then their goal LDL should be

A

< 100

26
Q

If patient has CHD, then lifestyle modifications should begin when LDL is

A

> 100

27
Q

If patient has CHD, then medications should begin when LDL is

A

> 130

28
Q

If a patient has 2 risk factors, then their goal LDL is _____; begin lifestyle modification at _____; begin medication at ______

A

< 130; >130; >160

29
Q

If a patient has 1 risk factor, then their goal LDL is _____; begin lifestyle modification at _____; begin medication at ______

A

< 160; >160; >190

30
Q

Therapy of choice of high LDL

A

Statins - HMG CoA Reductase Inhibitors

31
Q

Alternatives to statins:

A

Resin or Niacin

32
Q

ADA suggests that your total fat intake should be _________ of your total calorie intake

A

25-35% of your total calorie intake

33
Q

Restricting dietary intake of fat from 45% to 25% of total calories

A

Can lower total cholesterol by 15% and LDL by 25%

34
Q

Exercise can

A

raise HDL, lower TGs, no effect on LDL

35
Q

Statin Mechanism

A

HMG CoA Reductase Inhibitors i.e. prevent the rate-limiting step of cholesterol synthesis (HMG-CoA -> Mevalonate), decreases VLDL, LDL, slight increase in HDL

36
Q

Statins Side Effects

A

liver failure, rhabdomyolysis, myopathy/myositis

37
Q

Niacin

A

Inhibits lipolysis in adipose tissue and Increases HDL and lowers LDL

38
Q

Niacin Side Effects

A

Flushing (tx w/ aspirin)

39
Q

Bile Acid Resin Mechanism

A

Prevent the reabsorption of bile acids, liver must use cholesterol to make more; lowers LDL

40
Q

Bile Acid Resin have low compliance and

A

low efficacy; low complicate bc they taste terrible

41
Q

Ezitimibe

A

Prevents the absorption of dietary and biliary cholesterol in the GIT to decrease LDL

42
Q

Ezitimibe Side Effects

A

Diarrhea

43
Q

Fibrates Mechanism

A

lipoprotein lipase upregulation to increase TG clearance; Lowers TGs

44
Q

Fibrates Side Effects

A

Myositis (esp w/ statins), gallstones

45
Q

Statins decrease risk of coronary events bc

A

they also reduce inflammation; reduce stroke, MI, stabalize plaques

46
Q

What are CHD Risk Equivalent

A

PVD, DM, AAA, symptomatic carotid artery disease

CSI Exam 4 (11 decks)

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