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Cardiology IPAP > Slide set 5 > Flashcards

Slide set 5 Flashcards

1
Q

Major lipids transported by lipoproteins

A

Cholesterol and Triglycerides

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2
Q

Major Lipoproteins

A

LDL, VLDL, HDL, Chylomicrons

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3
Q

Dyslipidemia defined as

A

Abnormal circulating lipid levels

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4
Q

Primary Dyslipidemia is a result of

A

Genetics

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5
Q

Secondary Dyslipidemia is a result of

A

Lifestyle, DM, renal/thyroid DZ

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6
Q

Familial hypercholesterolemia mutation is at the

A

LDL receptor gene

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7
Q

Familial hypercholesterolemia is

A

Elevated cholesterol and premature CAD

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8
Q

Familial hypercholesterolemia pts may have what common S/S

A

Xanthomatous tendons FamHx hypercholesterolemia Elevated LDL in childhood

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9
Q

Familial Combined Hyperlipidemia is

A

Elevated LDL, Triglycerides and early CAD

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10
Q

Another name for HDL is

A

Apo-A1 lipoprotein

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11
Q

Another name for LDL is

A

Apo-B100 lipoprotein

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12
Q

Another name for Chylomicrons is

A

Apo-B-48 lipoprotein

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13
Q

Cholesterol screening recommendation is

A

Fasting lipid screening every 5 years >20yo

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14
Q

Calculate ASCVD risk when

A

Every 4-6y for those 40-75yo w/out DM/ASCVD and LDL 70-189 - not on statin

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15
Q

Predisposing statin Cis are

A

Multiple comorbidites Impaired Renal/Hepatic fx Hx of statin intolerance - muscle D/Os Unexplained ALT elevations >3x upper NL Taking drugs affecting statin metabolism >75yo

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16
Q

Cholesterol lab test contains

A

Total chol and HDL

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17
Q

What are the 4 statin benefit groups?

A

1.Pts with clinical ASCVD 2.Pts with primary elevations of LDL >190 3.Pts 40-75yo with DM and LDL 70-190 4.Pts 40-75yo with LDL 70-190 and >7.5%

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18
Q

ASCVD is defined as athersosclerotic origin of (3)

A

Acute coronary syndrome (MI, any angina) Revascularization Peripheral artery disease Stroke/TIA

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19
Q

What are the high intensity statins/doses

A

Atorvastatin 40-80mg Rosuvastatin 20mg

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20
Q

What are the low intensity statins/doses

A

Pravastatin 10-20mg Lovastatin 20mg

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21
Q

High intenstiy statin is expected to lower LDL by how much

A

> 50%

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22
Q

Mod intenstiy statin is expected to lower LDL by how much

A

30-50%

23
Q

S/S of statin use

A

Pain, Tenderness, stiffness, cramping, weakness, fatigue

24
Q

If pt has severe muscle S/S then

A

DC statin and perform a Rhabdomyolysis workup

25
Q

Rhabdomyolysis workup consist of

A

CK, Creatininte, and UA for myoglobinuria

26
Q

If pt has mild-mod muscle S/S then

A

DC and eval for hypothyroidism, renal-hepatic function, Vit-D deficency, primary muscle disease

27
Q

If pt’s mild-mod muscle S/S resolve and no other CI can be determined whats next for statin therapy

A

Start pt back on SAME statin at the original or lower dose and monitor. If S/S reoccur DC current statin and start low dose of another statin

28
Q

Can drugs such as estrogen replacement affect cardiovascular risk?

A

Yes (as a secondary cause)

29
Q

Treatment of hypertryglyceridemia

A

<200 - lifestyle 200-500 - lifestyle and txt of DZ process >500 - req Rx txt to avoid pancreatitis

30
Q

Meds to lower TG levels are

A

Fibrates, Nicotinic Acid, Omega 3’s

31
Q

What fibrates are used to lower TG levels?

A

Fenofibrates and Gemfibrozil

32
Q

How much can Omega 3s reduce TG levels

A

> 3gm per day can lower TG by 50%

33
Q

What is metabolic syndrome

A

3 or more risk factors indicating health issues

34
Q

TXT of metabolic syndrome

A

Lifestyle DM II prevention CV risk reduction Tob cessation Prevent/TXT HTN

35
Q

90% of the time the HCP fails the patient in treating CV risks by

A

Wrong drug/dose Pt required combo TXT Patient is noncompliant due to Ses

36
Q

Other drug choices for dyslipidemia

A

HMG-CoA reductase inhibitors Bile Acid-Binding agents Cholesterol Absorption inhibitors Niacin Fibrates

37
Q

What is another name for Statins

A

HMG-CoA reductase inhibitors

38
Q

MOA of HMG-CoA reductase inhibitors

A

Compete for HMG-CoA enz preventing cholesterol synthesis

39
Q

MOA of Bile Acid-Binding agents

A

POS charged agent binds NEG charged bile acids preventing reabsorption

40
Q

Bile Acid-Binding agents reduces what

A

LDL (difficult SEs however)

41
Q

MOA of Cholesterol Absorption inhibitors

A

Inhibitor of cholesterol uptake in the small intestines and causes reduced Chylomicron production

42
Q

Cholesterol Absorption inhibitors reduces what

A

LDL (works best in combo with statin)

43
Q

Niacin MOA allow for what to happen

A

Increased HDL, inhibits fatty acid release

44
Q

MOA of fibrates

A

Affects peroxisome proliferator receptor

45
Q

Fibrates will cause what to happen

A

Lower triglycerides and elevate HDL

46
Q

Ezetimbe is an example of what class of drug

A

Cholesterol Absorption inhibitors

47
Q

What factors are used to determine metabolic syndrome (5)

A

Obesity at waist Triglycerides level >150 HDL cholesterol level BP >130/85 Fasting glucose >110

48
Q

What are the waist circumferance criteria for M/F to determine metabolic syndrome?

A

M->40 in and F->35in

49
Q

What are the HDL criteria for M/F to determine metabolic syndrome?

A

M-<40 and F-<50

50
Q

What does ASCVD stand for

A

Atherosclerotic Cardiovascular DZ

51
Q

Before starting statin therapy what labs should be run

A

Fasting Lipid ALT CK 2ndry issues ( >500TG, >190LDL, >ALT 3xNL)

52
Q

What 3 statin benefit groups receive moderate intensty statins

A

Hx of clinical ASCVD and is >75yo DM 40-75yo with LDL 70-189 and <7.5% 40-75yo with LDL 70-189 and >7.5%

53
Q

What 3 statin groups receive high intensity statins

A

Hx of clinical ASCVD and is <75yo LDL >190 DM 40-75yo with LDL 70-189 and >7.5%

Cardiology IPAP (20 decks)

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