Therapeutics - Dyslipidemia Part 1 Flashcards
true or false
white women are at the highest risk for hyperlipidemia
FALSE
rates are similar among race and gender
true or false
hypertension is classified as ASCVD (atherosclerotic cardiovascular disease)
FALSE - it’s not
name some examples of ASCVD
ACS
MI
stable or unstable angina
CVA (stroke)
TIA (transient ischemic attack)
PAD (peripheral artery disease)
revascularization
differentiate between primary and secondary prevention in terms of LDL lowering
primary prevention - patient is at risk of ASCVD (doesnt have yet but is at risk – ie - a patient with HTN)
secondary - patient already has ASCVD (heart disease)
true or false
the higher the LDL cholesterol, the higher the risk of ASCVD
true
true or false
nonpharmacologic management is not important to lower LDL. medication is really the only solution
FALSE - nonpharm management like diet and exercise is very important
are there symptoms that a patient can watch out for to see if they have high cholesterol?
NO - not generally
if the pt has familial hypercholesteromemia – may get xanthomas – like bumps on the skin that contain lipids
also, may get pancreatitis, but only if TG levels are over 500mg/dL
true or false
familial hypercholesterolemia is a very high risk factor for getting heart disease (ASCVD)
true
true or false
acute pancreatitis does not present with symptoms
FALSE - it does
pt will get abdominal pain – have to go to ER
according to the older guidelines, how often should adults be screened for high cholesterol?
are there any exceptions?
generally - every 4-6 years
but if the patient has a history of heart disease or diabetes, or if family history – want to check more frequently – starting at 20 years old
how often should children/teens be screened for high cholesterol?
once
then again at age 17-21
but again - if diabetic or obese - may need more frequent screening
true or false
LDL automatically shows up in the lipid panel
FALSE - needs to be calculated
as mentioned, LDL is actually a calculated value using a formula
when would this formula not work?
it wouldnt work if triglycerides are over 400mg/dL
in this case, a direct LDL would have to be ordered (expensive!)
total cholesterol, in general, should be less than….
200mg/dL
HDL, in general, should be over….
40mg/dL
triglycerides should be less than….
150mg/dL
but high triglycerides really arent high risk for ASCVD unless also paired with high LDL/low HDL
also, over 500 is pancreatitis concern
a patient’s triglyceride levels come back as 168.
is this a concern? would we ask any follow up questions?
really not a concern. normal is less than 150. generally only a concern if very high
also, ask if the patient had a fatty meal before bloodwork, bc this can cause the TG to spike – ask to follow up in a couple days if she did have fatty meal
if a patient’s lipid panel comes back with hyperlipidemia, what is VERY IMPORTANT TO ASSESS?
if there are any secondary (underlying) causes of the high cholesterol
ie - diabetes, diet, metabolic issues (hypothyroidism, obese, pregannt), or even drugs can cause
name 3 altered states of metabolism that can be a secondary cause of hyperlipidemia
hypothyroidism
obesity
diabetes
___ or ___ fat consumption can be a cause of elevated LDL
high intake of ___ can be a cause of high TG
trans or saturated fat - increased LDL
eating lot of refined carbs - increased TG
true or false
if a patient has hypothyroidism and we treat it, their LDL should go down in turn
true
dont treat LDL as a second issue if it is due to a cause that can be treated
3 diet factors that can cause high LDL
3 diet factors that can cause high TG
high LDL - anorexia, weight gain, saturated oor trans fat
high TG - alcohol, weight gain, lot of refined carbs
true or false
medications cannot be an underlying cause of high cholesterol
FALSE - they can!
there’s a lot
however, most meds increase triglycerides more than they do cholesterol
explain thiazide diuretics and their increase on cholesterol and triglycerides
they really only increase them at doses of 50mg and over a day – not at normal doses