Hyperlipidemias Flashcards Preview

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Flashcards in Hyperlipidemias Deck (17)
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1
Q

What is a lipid profiled

A

Total Cholesterol
LDL
HDL
TGs

2
Q

Acanthosis Nigricans

A

Associated with insulin reisstance….seen in T2DM, PCOS, pre-diabetes

Suspect high TG, low HDL (TG>150)

3
Q

Eruptive xanthoma

A

Palpable, non-pruritic, usually on pressure points

Suspect high TG, low HDL (TG>1000)

4
Q

Tendon xanthoma

A

Visible or palpable thickening of achilles tendon, absence of previous injury

Associated with familial hypercholesterolemia, suspect very high TC, LDL (LDL>300)

5
Q

Lipemia retinalis

A

TG>2000

Chylomicronemia syndrome

Expect pancreatitis

6
Q

When to lower TGs

A

Over 1000 - YES

Under 150 - NO

200-500 - maybe

500-1000 - probably

7
Q

Cholesterol screening

A

Fasting lipoprotein every 5 years starting at age 20

If non-fasting, get full profile if TC>200 or HDL<40

8
Q

Assessment of risk

A

Count CV risk factors

If 2 or more, then calculate 10 year risk using Framingham risk calculator

9
Q

CVD risk factors

A
Smoking
HTN
FH of premature CHD 
Age (over 45 men, over 55 women)
HDL<40 
CHD or equiv - DIABETES
10
Q

ASCVD statin benefit groups

A

Under 75 y/o - high intensity
Over 75 - mod intensity

LDL>190 - high intensity

Diabetes, age 40-75 - moderate or high intensity

10 year risk>7.5 0 mod to high intensity statin

11
Q

High vs. low intensity statins

A

High - lowers LDL over 50…atorva 40,80 or rosuva 20,40

Mod - 30-50%

12
Q

High TGs

A

Diabetes, obsesity, dialysis, alcohol, B blocker, estrogen, resins, retinoids

13
Q

High cholesterol AND Tg

A
Hypothyroidism 
Nephrotic syndrome
Cushings
Acromegaly
Diuretics
Protease inhibitors 
Transplant meds
14
Q

Hetero FH mutations

A

LDLR or apoB or PCSK9

15
Q

Insulin def

A

Reduces LPL, inc VLDL production and dec VLDL clearance thus exacerbates hypertriglyceridemia

Other exacerbating favotrs include hypothyroidism, renal probs, alcohol, estrogen and other meds

16
Q

Statins for everyone?

A

Proven to dec CVD events in every population except CKD/Dialysis

No harm in youth

Potentially teratogenic

Risks of side effects

17
Q

PLacebo vs. nocebo

A

Place - benefit derived belief therapy active

Nocebo - hamr derived from belief therapy is harmful