SFP: dyslipidemias Flashcards
What is high cholesterol a major risk factor for?
Atherosclerotic and cardiovascular diseases
What events does high cholesterol increase the risk of?
MI, stroke, aortic aneurysm and dissection, PVD
What molecule is unequivocally atherogenic?
LDL
What cholesterol molecule is considered protective?
HDL
At what age do we typically start cholesterol screening?
40-75, unless there is a history or risk factors
What condition is a one-way ticket for treatment of cholesterol?
Diabetes
An LDL of over what value indicates treatment?
190
What is the LDL range for considering treatment?
70-190
What risk ratio indicates treatment options?
7.5-20
What is CAC scoring?
Looking for calcium in the arteries
What age do we start screening for hyperlipoproteinemia in men? Women?
35 in men, 45 in women
What tests do we do for hyperlipoproteinemia?
Total cholesterol, HDL, LDL, triglycerides
How can we calculate LDL?
LDL = total cholesterol – HDL – (triglycerides/5)
What is a normal triglyceride: cholesterol ratio in VLDL?
5:1
In what instances can we not use the equation for LDL?
Super high triglycerides, presence of chylomicrons, or in people with familial dysbetalipoproteinemia
What is associated with causing premature atherosclerosis?
LDL (not just triglycerides alone)
What are tendinous xanthomas?
Lipid deposits in soft tissue of Achilles tendons, elbows, or knees. This is due to increased LDL and often remain even with treatment.
What are tuberous xanthomas?
Deposits often on knees and elbows that can mimic tumors and are due to increased LDL. They may regress with treatment.
What are xanthelasmas?
Yellow plaques around the eyes that are associated with high cholesterol and LDL. This is very suggestive in younger patients.
What are eruptive xanthomas?
Clusters of yellow-white papules or nodules that can be seen in those with elevated triglycerides, chylomicrons, or VLDL. Often seen in uncontrolled diabetes and responds to treatment.
What is acute pancreatitis?
Inflammation of the pancreas that can be due to elevated triglycerides (chylomicrons or VLDL)
What is lipemia retinalis?
Condition associated with elevated triglycerides (chylomicrons or VLDL) that causes a milky appearance of the vessels and visual acuity changes. This can return to normal with treatment. Most commonly familial.
What is palmar xanthoma?
Yellow plaques on the palms that is associated with elevated triglycerides and cholesterol. Most commonly familial.
What condition alters cholesterol but not triglycerides?
Hypothyroidism
How does obesity impact lipids?
Increases triglycerides, FA synthesis, and VLDL. HDL decreases.
How does diabetes type 1 impact lipids?
Doesn’t usually cause hyperlipidemia, but diabetic ketoacidosis can cause increased transport of FFA to liver which can increase triglycerides.
How does diabetes type 2 impact lipids?
They’re dyslipidemic even under good glucose control; they have decreased LPL activity, increased release and synthesis of FFA, increased VLDL production, and decreased HDL.
How is LDL impacted in diabetes type 2?
It is not increased.
How does hypothyroidism impact lipids?
Increased LDL due to reduction in receptor function, increased IDL.
How does nephrotic syndrome impact lipids?
Mixed hyperlipidemia that can present with high cholesterol or triglycerides due to hepatic production and decreased clearance of VLDL with increased LDL production.
How does chronic renal failure impact lipids?
Mildly high triglycerides due to VLDL accumulation, followed by eventual impaired lipolysis and clearance of chylomicrons and VLDL. Prone to heart issues.
How do renal transplants impact lipids?
Hyperlipidemia due to immunosuppressive drugs.
How does hepatitis impact lipids?
Increased VLDL synthesis leads to hypertriglyceridemia.
How does liver failure impact lipids?
Decreased lipoprotein synthesis leads to decreased cholesterol and triglycerides.
How does cholestasis impact lipids?
Blocks excretion of cholesterol into bile, which increases LDL/HDL.
How does alcohol impact lipids?
Variable; can increase triglyceride levels by stimulating hepatic secretion of VLDL and may inhibit oxidation of FFA, promoting triglyceride synthesis. Increases HDL.
How does estrogen impact lipids?
Increases VLDL and HDL, and may increase plasma triglycerides; it is cardio protective.
How does Cushing’s syndrome impact lipids?
Increased VLDL hypertriglyceridemia; might be mild LDL elevation.
