Sperling- Clinical Correlation: lipids and atherosclerosis Flashcards
when born, what is physiological LDL level and what is the pattern after birth?
30-70 mg/dl, but it increases as you age unless you have a favorable genetic mutation
Name 4 causes of dyslipidemia
- diet
- genetic
- metabolic
- drug effects
Name some metabolic causes of dyslipidemia
- insulin resistance
- hypothyroidism
- hormones
name some causes of secondary dyslipidemia
- diabetes
- hypothyroidism
- obstructive liver disease
- chronic renal failure
- drugs raising ldl cholesterol and lower hDL cholesterol (ACCUTANE)
what is secondary dyslipidemia
- not something entirely genetic, but something that can be ameliorated with changes in meds, lifestyle
What factors predict 2/3 of MI’s worldwide
- cigarette smoking
2. LDL/HDL ratio
what other factors did the interheart study eluxidate in terms of risks of CVD
- HTN
- DM
- abdominal obesity
- stress/depression
- no exercise
- no fruits/veggies
Name 5 pharmacotherapy options for dyslipedmia managment
- statins
- niacin
- fibrates
- cholesterol absorption inhibitors
- bile acid sequestrants
__________ is the cornerstone for reducing CV disk
- lifestyle management
average LDL in US gene pop is _______
frequency of FH
1/250
What is relationship between FH and Coronary heart disease/ MI’s?
- 20 fold increase risk of CHD
- causes 20% of MI’s before age 45 and 5% before age 60
effect of FH heterozygous mutation on cholesterol? homozygous?
- 2x normal LDL
- 4-5x LDL and early atherosclerosis
Physical characteristics of FH
- Xanthelasma
- arcus corane
- xanthoma
- achilles tendon xanthoma
What populations have a very high prevalence of FH and why?
- French canadians, christian lebanese, south africans, ashkenazi
FOUNDER EFFECT
Name some therapies for FH
- combination lipid therapy
- STATINS (not overly affective in homozygotes because they have no LDLR)
- ** LDL apheresis (like a dialysis to wash the LDL out)
