Flashcards in Hyperlipidaemia Deck (6):
What is Hyperlipidaemia?
Lipids travel around the body in the form of Lipoproteins
• VLDL – Triglyceride from liver to tissue
• Chylomicrons - Triglyceride from gut to liver
• LDL - Cholesterol from liver to body
• HDL - Phospholipid from body to liver
Hyperlipidaemia is a term used to describe when there is too much total cholesterol, LDL, Triglyceride or a mix of the above. This leads to increased cardiovascular risk due to increased atheroma formation. As such we screen people with signs of Hyperlipidaemia or those with a family/medical history of cardiovascular disease. HDL is not a risk factor and is cardio protective.
What are the causes of Hyperlipidaemia?
Common – Primary Idiopathic Hyperlipidaemia
Others – Diabetes, Pregnancy, Obesity, Alcohol, Cushing’s, Hypothyroidism, CKD (Nephrotic Syndrome), Obstructive Jaundice
What will you ask about/ find on history of a patient with suspected Hyperlipidaemia
Asymptomatic – However there may be physical signs in familial hyperlipidaemia
If in teens/20's consider familial Hyperlipidaemia
Cardiovascular risk factors
Specific questions to ask in a history taking:
Ask about diet and exercise - get an idea of how they live (specifically looking for high saturated fats and sedentary lifestyle)
Ask about causes of secondary Hyperlipidaemia
Other associated conditions - High Blood Pressure, Diabetes
If treatment resistant, consider referral for familial hypercholesterolaemia
What will you look for/ find on examination of a patient with suspected Hyperlipidaemia
End of the bed:
Obesity (Risk Factor)
Elbow- tendon xanthomata (Familial)
Corneal Arcus (Familial)
Achilles - tendon xanthomata (Familial)
What investigations will you order in suspected hyperlipidaemia?
Glucose -To assess other cardiovascular risk factors and to rule out secondary hyperlipidaemia due to diabetes
Lipid Profile - Consists of Total Cholesterol, triglycerides, LDL, HDL, and non-HDL-cholesterol. These can also be altered in acute illness so consider patient status
TFT - Hypothyroidism can be a cause of secondary hyperlipidaemia
U&E - Assess renal function as CKD/Nephrotic Syndrome can be a cause of secondary hyperlipidaemia
LFT - Will likely be giving a statin so need to know baseline liver function and also looking for fatty liver which is associated with hyperlipidaemia