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T IoD biochemistry > Lipids and cardiovascular disease > Flashcards

Lipids and cardiovascular disease Flashcards

1
Q

what are modifiable risk factors for heart disease?

A
  • smoking
  • diet
  • BMI
  • exercise
    cholesterol
    -BP
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2
Q

what are non modifiable risk factors for heart disease?

A
  • family history
  • sex
  • age
  • ethnicity
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3
Q

what other illnesses are linked with hyperlipidaemia?

A
  • MI
  • acute pancreatitis
  • xanthelasma
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4
Q

what are clinical signs of hyperlipidaemia?

A

Tendon xanothoma

  • corneal arcus
  • thickening of the achilles
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5
Q

what are causes of secondary hyperlipidaemia?

A 
Diabetes
Hypothyroidism
Renal Disease
Liver disease
Alcohol
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6
Q

what baseline investigations should be done on all patients with lipid disorders?

A
  • lipid profile
  • U and E
  • LFT
  • ggT
  • fasting glucose
  • TFT
  • urine dipstick
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7
Q

what is the cut off for a specialist referral due to hyperlipidaemia?

A

TC>9 or non HDL>7,5 even if there is no family history

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8
Q

what is the defect in autosomal dominant hypercholesterolaemia?

A

defect of LDL APO B receptor gene

Less cholesterol efflux

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9
Q

what is PCSK9?

A

A serine protease

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10
Q

what is the effect of PCSK9?

A

When they bind to LDL it causes both of their degradations

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11
Q

why are PCSK9 inhibitors a potential treatment for hyperlipidaemia?

A

PCSK9 causes destruction of LDL receptors meaning less clearance
when inhibited more LDL receptors can be recycled to the cell surface to take up more LDL cholesterol

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12
Q

what is the role of LDLRAP1?

A

mediates the position of the LDL receptors to the coated pits

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13
Q

what is remnant disease?

A

There is accumulation of LDL remnant particles

Will have high lipids and triglycerides

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14
Q

what is the defect in remnant disease?

A

In apoE2

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15
Q

how is hyperlipidaemia classified?

A

Depending on triglycerides and cholesterol levels

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16
Q

what is type IIA?

A

Just very high cholesterol

Can be familial hypercholesterolaemia

17
Q

what is type IIB?

A

Very high cholesterol
slightly high triglycerides
can be familial combined hyperlipidaemia

18
Q

what is type III?

A

High cholesterol and high triglcyrides

Increased in IDL

19
Q

what is type IV?

A

Very high triglyceride and cholesterol

Often secondary

20
Q

what is type I/V?

A

Very high triglycerides with a slightly raised cholesterol

21
Q

what is the NICE specified risk scoring system for cardiovascular disease?

A

QRISK2

22
Q

What does QRISK2 take into account?

A
  • age
  • gender
  • ethnicity
  • smoking
  • diabetes
  • family history
  • AF
  • medications
  • RA
23
Q

what lipoproteins does the Apo A1 test measure?

A

HDL

24
Q

what lipoproteins does the Apo B100 test measure?

A

LDL
IDL
VLDL

25
Q

Values above which number for the Lp test are associated with increase CVD risk?

A

300mg/l

26
Q

values above which score on CRP are associated with increased CRP risk?

A

3

27
Q

what lifestyle advice can be given for hyperlipidaemia?

A
  • eat a cardioprotective diet
  • physical activity
  • weight management
  • alcohol
  • smoking cessatation
28
Q

how does ezetimibe work?

A

Inhibits gut absorption of cholesterol and inhibits VPCILI a lipid transporter

29
Q

what is the criteria for diagnosing an acute MI?

A

Two of:

  • clinical features like chest pain
  • ECG changes
  • cardiac enzyme changes
30
Q

Other than a heart attack what else can cause raised troponin?

A
  • Primary ischaemic cardiac injury due to an acute coronary syndrome mainly a ruptured plaque

Secondary ischaemic cardiac injury

Non ischaemic cardiac injury

31
Q

what are causes of non ischaemic cardiac injury?

A
  • myocarditis causes such as viral
  • cardiac trauma
  • inflammation
  • auto immune
  • drugs

T IoD biochemistry (4 decks)

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