Lipidology Flashcards

1
Q

Type I (Chylomicrons)

A

Contain TGAs
Defect dec’d familial LPL, CII
Skin lesions: eruptive xanthomas

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2
Q

Type II (LDL)

A

Contains: LDL
Defect - dec’d LDL rct’s
Skin lesions: Tendon, xanthomas

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3
Q

Type III (IDL)

A

Contains: LDL+TGAs
Defect Abnormal APoE
Skin lesions: Palmar/Tuberous Xanthomas

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4
Q

Type IV (VLDL)

A

Contains: TGAs
Defect dec’d familial LPL, CII
Skin Lesions: Eruptive Xanthomas

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5
Q

Type V (VLDL+Chylomicrons)

A

Contains: TGAs
Defect dec’d familial LPL, CII
Skin Lesions: Eruptive Xanthomas

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6
Q

Statins

A

Primary LDL tx, dec’s LDL, inc’s TGA, inc’d HDL
S/E - inc’d LFTs, CPK, wt gain
Glucose intolerance

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7
Q

Fibric Acid derivatives

A

Primary TGA tx
Inc’d /N LDL, dec’d TGA, inc’d HDL
S/E Gallstone, hepatoma

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8
Q

Bile Acid derivatives

A

Secondary LDL tx
dec’d LDL, TGAs, inc’d HDL
S/E Bloating, constipation, nausea

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9
Q

Nicotinic Acid

A

Primary HDL, secondary LDL
dec’d LDL, very dec’d TGA, very inc’d HDL
S/E Abd pain, nausesa, flushing, dry skin

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10
Q

Ezetimibe

A

TGA tx, seconary LDL

dec’d LDL, dec’d TGA

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11
Q

Apo protien E def

A

Type III

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12
Q

Def of LDL rct’s

A

Type IIa

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13
Q

Tendon xanthomas

A

Type IIa

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14
Q

Pancreatitis

A

Type I, IV, V

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15
Q

Pt with LDL 140, TGA 600 -0 fhx hypertriglyceridemia

A

Fibrinc acid derivative (gemfibrozil, fenofibrate)

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16
Q

Which reduces TG of 500 in pt with BMI 30

A

Losing wegith 5-10%
Defect - C II def - eruptive xanthoma
Tx: Gemfibrozil

17
Q

Palmar Xanthoma

A

Most likely defect Apo E

18
Q

Chol guidelines

A

No CAD, 0-1 risk factor LDL <130

19
Q

CAD equivalent risk factors

A

DM, Vascular dz, multiple risk factors with 10 year framingham >20%

20
Q

Treatment

A
First line = diet
Goo fats, < 200mg chol
15% calories from protienes
excercise 1hr/day, 5 days/ week
smoking cessagion
21
Q

Reynolds vs Framingham

A

Reyolds include high sensitivety CRP
Parental h/o MI
Accounts for gender…

22
Q

Pt wants alternative med for prevention of CAD

A

Omega 3 fatty acid

23
Q

40yo no risk factors for CAD with LDL 175

A

first diet/excercise

24
Q

Pt with DM likely has…

A

inc’d LDL, inc’d TGA, dec’d HDL

25
Q

Primary target for therapy in DM pt

A

LDL

26
Q

62yo F with HTN and DM2 requests advice of CAD risk reduction BP 152/92, A1c 7.6, chol 268, LDL 180, HDL 42

A

Statin for LDL <100

27
Q

What is initial drug for DM pt with LDL 160, TGA 250, HDL 45

A

Statin

28
Q

57yo F with MI, quits smoking, changes diet, started on zocor 20 LDL 180 to 140, TGA 350 to 250, HDL 48 wtd?

A

inc to zocor 40

29
Q

Pt over age 50, LDL 140, CRP more than 2mg - what will dec mortality?

A

Statin

30
Q

Pt on zocor - 8 wks later with genralized myalgias, CPK 75, AST/ALT 30/40 dz?

A

statin induced myalgia

Best management - switch to pravastatin

31
Q

67yo M c/o pain/wk legs, difficulty getting up from seated postion, stpped taking lipitor 3 mo ago after CPK elevated - - repeat CPK 1925 - not much change - mulscel bx necrotizing fibers no inflamm, no vaculole - dx?

A

Statin induced myopathy 2/2 to HMGCR

32
Q

Hyperlipidemia in pregnancy

A

Colesevelam (welchol)

33
Q

Lipitor 40-> 80 - AST/ALT up but not 2x ULN, LDL now 80 , HDL now 59, wtd?

A

continue current dose

34
Q

40yo M strong fhx prem MI LDL 130, HDL 28, TGA 175 what is elevated?

A

Lp(a) (dec’d HDL)

tx: Niacin

35
Q

Prevention of flushing aw Niacin

A

ASA 30min prior

36
Q

55yo M strong fhx premature coronary dz LDL 180, HDL 29, TGA 375 - started on zocor 40 - LDL now 120, HDL 35, TGA 245 wtd?

A

continue zocor, add niacin

37
Q

Pt on zocor with Wk CPK 850

A

d/c zocor

38
Q

Pt for regular checkup LDL 150 TG 160, HDL 80 wtd?

A

No need for meds