Dyslipidimia

Question 1

Classification of Dyslipidemia

Answer 1

• predominant hypertriglyceridaemia
• predominant hypercholesterolaemia
• mixed pattern with elevation of both cholesterol
and triglyceride (TG

Question 2

Summary of studies that reinforce the benefits of lipidlowering therapy for dyslipidaemia and the primary
prevention of coronary heart disease (CDH).

Answer 2

4S, 2 PLACI, 3 PLACII, 4 ACAPS, 5 KAPS 6

and REGRESS

Question 3

One systematic review showed that ______ and __________ are the most favourable lipid-lowering
interventions, with reduced risks of overall and
cardiac mortality

Answer 3

statins and

n-3 fatty acids

Question 4

Major risk factors for CAD include:
1
2

Answer 4

— increased LDL cholesterol + reduced HDL
cholesterol
— ratio LDL-C:HDL-C >4

Question 5

Risk increases with increasing cholesterol levels

(90% if >_______

Answer 5

7.8 mmol/L

Question 6

TG levels >10 mmol/L increases risk of

________

Answer 6

pancreatitis

Question 7

10% reduction of total cholesterol gives _______

reduction in CAD after 3 years

Answer 7

20%

Question 8

Common causes of secondary

dyslipidaemia

Answer 8

Hypothyroidism
Nephrotic syndrome
Type 2 diabetes
Cholestasis
Anorexia nervosa
Obesity
Kidney impairment
Alcohol excess
Obstructive liver disease

Question 9

Recommended treatment goals
• Total cholesterol \_\_\_\_\_\_\_\_
• LDL-C \_\_\_\_\_\_\_\_\_*
• TG \_\_\_\_\_\_\_
• HDL-C ≥ \_\_\_\_\_\_
• non-HDL-C <2.5 mmol/L

Answer 9

<4.0 mmol/L
<2.0 mmol/L
<2 mmol/L
1.0 mmol/L

Question 10

Dyslip Treatment should commence with a_____

Answer 10

statin.

Question 11

If
LDL-C levels are not reduced to target levels or a
maximally tolerated dose on a statin, add one of
________, _______, ______

Answer 11

ezetimibe,bile acid binding resin or nicotinic acid.

Question 12

SE of statins

Answer 12

GIT side effects, myalgia,

abnormal liver function (uncommon

Question 13

In statin Tx, repeat LFTs after

Answer 13

4–8 weeks, then every 6

weeks for 6 months

Question 14

Combination: ezetimibe + statin (especially if

_________

Answer 14

cholesterol below target)

Question 15

Bile acid binding resins:
• e.g. __________ 4 g daily in fruit juice
increasing to maximum tolerated dose

Answer 15

cholestyramine

Question 16

_________ consider if above drugs not tolerated

Answer 16

Fibrates:

Question 17

Adverse effects of nicotinic acid

Answer 17

flushing, gastric irritation,

gout

Question 18

Mx of Resistant LDL-C elevation

Answer 18

1 Combination statin + ezetimibe
2 Combined statin and resin
cholestyramine 4–8 g (o) mane
plus
a statin

Question 19

Moderate to severe (isolated or

predominant) TG elevation

Answer 19

Fibrate:

gemfibrozil 600 mg (o) bd
or
fenofibrate 145 mg (o) daily

Question 20

Massive hypertriglyceridaemia

(TG) 10 mmol/L:

Answer 20

fibrate plus fish oil plus (if necessary) nicotinic acid

Question 21

Mixed hyperlipidaemia (↑ TG + ↑ LDL-C)

• If TG <4: a ________
• If TG >4: a ________

Answer 21

statin

fibrate

Question 22

Statin + gemfibrozil increases risk of

______and requires specialised supervision

Answer 22

myopathy