Pathophysiology of Dyslipidemia and Atherosclerosis Flashcards
exogenous generation
dietary lipids are emulsified with bile acids so they care be transported by chylomicrons
endogenous generation
Liver secretes VLDL which is converted to IDL which is converted to LDL
Uses for lipids
- A source of energy in skeletal muscle
- A source of storage in adipose tissue
- Support cell membrane structure
- A precursor to steroid hormone synthesis
cholesterol equation
Total cholesterol = LDL + HDL + (TG ÷ 5)
desirable total cholesterol
< 200
high total cholesterol
> 240
desirable LDL
< 100
high LDL
160-189
very high LDL
> 190
desirable TG
< 150
high TG
200-499
very high TG
> 500
low HDL
< 40
high HDL
> 60
the features of familial hypercholesterolemia
- xanthomas
- extreme LDL elevations and presents early in life
- Autosomal dominant disorder
- Patients develop early vascular disease
- Often related to a defect with LDL binding to the LDL receptor for clearance
Drugs that cause High total cholesterol and LDL
Clubbing is the best place; getting more perfect selfies.
- cyclosporine
- isotretinoin
- thiazide diuretics
- beta-blockers
- protease inhibitors
- glucocorticoids
- mirtazapine
- Progestins
- sirolimus
Drugs that cause High TG
I B MAS BIG TEA
- Isotretinoin
- beta blockers
- mirtazapine
- Alcohol
- sirolimus
- bile-acid sequestrants
- interferons
- glucocorticoids
- thiazides
- Estrogens
- anabolic steroids
Drugs that cause Low HDL
PAIN
- progestins
- anabolic steroids
- isotretinoin
- non-ISA beta blockers
atherosclerosis
a physical change in arterial vessels that impairs proper blood flow and limits oxygen to vital organs causing ischemia
What does plaques consists of?
- lipids
- inflammatory cells
- smooth muscle cells
- connective tissues
ASCVD
- Coronary arterial disease (CAD)
- acute coronary syndrome (ACS)
- myocardial infarction (MI)
- Cerebrovascular disease or cerebrovascular accident (CVA)
- Peripheral arterial disease (PAD)
risk factors included in the Pooled Cohort Risk Assessment Equation
- Sex
- Age
- Race
- Diabetes
- HTN and BP
- Smoking
- Total and HDL cholesterol
What is the threshold a person’s risk of developing atherosclerotic disease is considered “high” based on the Pooled Cohort Risk Assessment Equation?
7.5%
What are the criteria for metabolic syndrome?
In order to be considered to have metabolic syndrome, must meet 3 or the 5 risk factors:
- Central obesity (waist circumference: women > 88 cm or men > 102 cm)
- Elevated TG > 150 mg/dL
- Low HDL (< 40 mg/dL)
- Hypertension
- Elevated fasting glucose (> 100 mg/dL)
