Lipids

Question 1

Physical signs of severe hypercholesterolemia

Answer 1

1- tendinous xanthoma
2- xanthelasma - less specific
3- arcus cornealis

Question 2

Order of particles from high TGs to low TGs

Answer 2

1) chylomicron (intestinal)
2) VLDL
3) LDL
4) HDL

Question 3

Which 2 particles have the ApoB100 on them?

Answer 3

VLDL

LDL

Question 4

In a lab test the Triglycerides are a measure of which particle?

Answer 4

VLDL

Question 5

Tissues that break down triglycerides/contain lipoprotein lipase

Answer 5

Muscle and fat

Question 6

A 1mmol/L reduction in LDL is associated with

Answer 6

23 and 21% reduction in major coronary and vascular events

Question 7

How does HMG coA reductase work?

Answer 7

By inhibiting cholesterol synthesis and upregulating LDL receptor

Question 8

how much more does 80 mg Atorvastatin reduces risk of CV events compared with 10mg

Answer 8

22%

Question 9

3 doublings of the statin dose only leads to a

Answer 9

18% reduction in LDL-C

Question 10

The first reduction in LDL-C is

Answer 10

40% reduction

Question 11

how does ezetmibe work?

Answer 11

blocks the absorption of cholesterol in the intestine

reduces TG,

Question 12

Single dose ezetimibe 10mg is the same as

Answer 12

3 dose titration of a statin from 20 to 40 to 80 mg - 18% reduction

Question 13

what is the effect on CV health of addition of ezetimibe to a statin (40mg)

Answer 13

incremental benefit - 6% reduction in risk

Question 14

Ideal TG levels

Answer 14

< 1.7

Question 15

Extreme elevation in fasting TG levels and health risk

Answer 15

> 10mmol/L –> pancreatitis

Question 16

MODEST elevation in fasting TG levels and health risk

Answer 16

3- 10 mmol/L –> CHD

Question 17

Acute treatment of pancreatitis secondary to hypertriglyceridemia

Answer 17

• NPO(reduce chylomicron TGs)
• FLUIDS
• Low fat diet

Question 18

Pharmacologic therapies of HIGH triglycerides

Answer 18

• Fibrates
• Niacin
• omega 3s
• Statins

Question 19

Physical signs of severe hypertriglyceridemia

Answer 19

• Lipemia retinalis

- Eruptive xanthomas - acute lesions

Question 20

How does alcohol affect TGs?

Answer 20

increases production of VLDL

Question 21

Mechanism of action of fibrates

Answer 21

• Activate LPL

- Lower TGs

Question 22

Intermediate risk level of FRS

Answer 22

10-19%

Question 23

When do you treat an intermediate risk patient?

Answer 23

If LDL >= 3.5 mmol/L

if LDL < 3.5 but ApoB >1.2 or non-HDL-C >4.3

Question 24

What 2 risk modifiers are not included in the Framingham calculator?

Answer 24

1- family Hx - (multiple by 2)

2- Metabolic syndrome - (High LDL, low HDL, hypertension, IGT)

Question 25

how do we calculate LDL-C?

Answer 25

Total cholesterol = (TG/2.2)+ LDL+ HDL

Question 26

When is the formula to calculate LDL invalid

Answer 26

when TG > 4.5

Question 27

Non-HDL-C refers to all

Answer 27

ApoB containing molecules

Question 28

Primary treatment target is always

Answer 28

LDL (<2 or 50% reduction)

Question 29

Bile acid sequestrants can be used if not on target

Answer 29

can help reduce diabetes

with ezetimibe can reduce LDL by 40-45%

Question 30

Effects of niacin on LDL, HDL, and TG

Answer 30

Decrease LDL by 20%
increase HDL by 30%
Decrease TG by 40%