Dyslipidaemias

Question 1

What are statins?

Answer 1

Lower cholesterol levels

Question 2

If statins don’t regulate cholesterol, what else can you use?

Answer 2

Ezetimbe
(Lipid regulating drug)

Question 3

What are the three lipid abnormalities?

Answer 3

Low density lipoprotein cholesterol (LDL-C)

Triglycerides (TG)
Or both

High total cholesterol (TC)

Question 4

What is the complication of hyperlipidaemia?

Answer 4

CVD
Atherosclerosis

Question 5

What’s hypercholesterolaemia?

Answer 5

Elevated levels of Tc or LDL or both

Question 6

What is hypertriglyveridaemia?

Answer 6

Elevated levels of Triglycerides

Question 7

What is familial hyperlipidaemia?

Answer 7

Elevated serum lipids due to genetic defects in lipid metabolism

Question 8

What is the difference between HDL and LDL?

Answer 8

HDL helps remove excess cholesterol from the bloodstream reducing risk of atherosclerosis while,

LDL they get elevated and contribute to the development of atherosclerosis, increased CVD such as stroke and heat attacks

Question 9

What causes hyperdyslipidaemia?

Answer 9

Genes (familial)
T2D, obesity, smoking,alcohol,drugs,hypothyroidism,nephrotic syndrome,cholestasis

Question 10

Very high lipid can affect what part of your body?

Answer 10

Eye
Skin
Elbow

Question 11

List the three things that you can get due to having high lipid level?

Answer 11

Xanthelasma
Corneal arcus lipemia
Tendon xanthoma

Question 12

What is xanthelasma

Answer 12

Yellow cholesterol deposits around the eyelids

Question 13

What is corneal arcus lipemia?

Answer 13

White of grey ring that appears around the peripheral cornea

Question 14

What is tendon xanthoma

Answer 14

Enlargement of tendons around knuckles

Question 15

List examples of statins

Answer 15

Atorvastatin
Simvastatin
Fluvastatin
Rosuvastatin
Etc

Question 16

List examples of fibrates

Answer 16

Fenofibrate
Clofibrate
Gemfibrozi

Question 17

List examples of other lipid lowering drugs

Answer 17

Ezetimibe
Bempedoic acid
Nicotinic acid
Evinacumab

Question 18

List examples of bile acid sequestrants

Answer 18

Cholestyramine
Colestipol

Question 19

What is the first line treatment?

Answer 19

Statins

Question 20

How does statins work?

Answer 20

Lowers LDL cholesterol by inhibiting HMG-CoA reductase

Question 21

How does statins work?

Answer 21

Lowers LDL cholesterol by inhibiting HMG-CoA reductase

Question 22

What do you use when statins are not tolerated or when cholesterol levels not achieved?

Answer 22

Ezetimibe
As mono therapy or in combination with statin

Question 23

Why do we not use bile acid sequestrants?

Answer 23

Limited use
Poor tolerability and compliance
Declining use

Question 24

When do you use fibrates ?

Answer 24

Consider if dietary interventions and statins and ezetimibe are not tolerated

Use under specialist supervision

Question 25

How are fibrates beneficial?

Answer 25

May be beneficial in those with low HDL cholesterol or raised triglycerides

Question 26

If you combine statins and fibrates, what happens?

Answer 26

Increase risk of muscle related side effect (Rhabdomyolysis)

Question 27

What happens when you combine statins with fibrates

Answer 27

Increased risk of muscle related side effects (Rhabdomyolysis) Eg gemfibrozil

Question 28

Lost drugs for primary heterozygous familial hypercholesterolaemia whose LDL-cholesterol has not been adequately controlled on maximum tolerated lipid-lowering therapy?

Answer 28

Alirocumab evolocumab

Question 29

Patient should undergo a lipid lowering check after how many months?

Answer 29

3 months

Question 30

What is the target of reducing non HDL cholesterol?

Answer 30

40%

Question 31

High strength of simvastatin (80mg) causes what?

Answer 31

Myopathy

Question 32

Which statins should be taken in the morning?

Answer 32

Rosuvastatin Atorvastatin

Question 33

List medium intensity drugs?

Answer 33

Atorvastatin 10mg Simvastatin 20, 40mg Fluvastatin 80mg Rosuvastatin 5mg

Question 34

List low intensity drugs?

Answer 34

Fluvastatin 20, 40mg Pravastatin 10,20,40mg Simvastatin 10mg

Question 35

When do you give people 80mg simvastatin

Answer 35

hypercholesterolaemia and high risk of cardiovascular complications who have not achieved their treatment goals on lower doses