dyslipidemia Flashcards by Grace Dewling

hyperlipidemia is a big risk factor for ____ disease

Cardiovascular, heart attack and stroke

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hyperlipidemia doubles the risk for _____

cardiovascular disease

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what is formed from too much cholesterol

atherosclerosis, plaque formation in arteries

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what is the function of cholesterol

cholesterol is a waxy substance which helps to produce vitamin D

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HDL stands for _______ lipoprotein aka ______ cholesterol, works to remove excess ______

high density

good

cholesterol

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LDL stands for ______ lipoprotein aka, ____ cholesterol, and it works to contributes to ___ buildup

low density

bad

plaque

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VLDL stands for _______ lipoprotein, it is ___ cholesterol, it carries ______

very low,

bad

triglycerides

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modifiable risk factors for hyperlipidemia include

diet

physical activity

smoking

obesity

ETOH

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non modifiable risk factors for hyperlipidemia

genetics

age

gender

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cholesterol is a precursor for synthesis of _____ hormones, and vitamin ___

steroid

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how is cholesterol transported

within lipoproteins (LDL, HDL

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what lifestyle facotors can lead to hyperlipidemia

high fat diet,
sedentary lifestyle,
obesity,
smoking,
and
excess alcohol

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pathophys of LDL

LDL accumulates,

oxidation, macrophages react, and absorb excess LDL which leads to foam cells.

foam cell accumulation which leads into plaque formation

as plaques become enlarged they rupture, and cause a heart attack or a stroke

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what is the role of HDL in body (pathophys)

protective and antiinflammatory effects

decrease LDL oxidation
promote vasodilation
prevent cell death
prevent clot formation
keep blood flowing,

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types of hyperlipidemia

types of hyperlipidemia include

primary hyperlipdiemia-
(genetic causes, familial hypercholesteremia)

secondary hyperlipidemia- caused by lifestyle or diabetes, kidney disease, thyroid disease, obesity

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hyperlipidemia familial cause AHA criteria

LDL > 190
1st degree relative w/ LDL >190
1 st degree relative with known CHD

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hypertriglyceridemia can be ____ or _____

genetic or acquired

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hypertriglyceridemia increases the risk for _______

pancreatitits

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normal triglyceride level is less than

<150

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mild hypertriglyceridemia

150-499 mg/dl

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moderate hypertriglyceridemia

500-886

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hyperlipidemia physical exam may see what findings but not common

xanthoma, yellow deposit formed around the eyelids

arcus senillus, white ring around the cornea

tendon xanthomatosis- yellow tendons found mostly around the hands and the feet

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if 10 yr ASCVD risk is below <5% will you recommend statin therapy?

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if 10 yr ASCVD risk falls between 5-7.5% then is statin therapy recommended ?

would consider low to moderate dose of a statin

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if 10 yr ASCVD is greater than 7.5% then would do ___ dose statin

high

hyperlipidemia high risk

multiple ASCVD events one major ASCVD event and > 2 high risk condition high risk conditions history of MI, PAD, CKDm HTN, DM history of CABG

ASCVD events include

stroke MI

in the treatment for hyperlipidemia what should all patients be educated on?

physical activity, diet (mediterranean diet is the best diet)

all diabetes pt with LDL >__ need to be on a moderate statin

1st line tx for hyperlipidemia

statins

statins inhibit enzyme ______

HMG-COA reductase

common side effect of statin

muscle pain, liver damage, nausea, diabetes

statin is contraindicated in ______

liver disease and pregnancy

if CK levels >10 the upper limit, then immediate ___ statin

discontinue recgeck after 2 weeks, can resume lower dose of statin

if high CK and AKI (acute kidney injury, what is that a sign of from statin therapy? what should you do?

discontinue statin, and aggresive hydration as this is a sign of rhabdomyolysis

high intensity statins

atorvastatin, 80 mg rosuvastatin. 40 mg

mod intensitity statin

atorvastatin, 20 rosuvastatin, 10 mg simvastatin, 20-40 mg pravastatin, 40

low intensity statin

simvastatin, 10 mg

second line tx if first line (statin) had failed

ezetimibe

ezitimibe impairs absorption of ______

cholesterol

ezitimibe well tolerated but can cause _____ and ______

diarrhea, lft elevation

bile acid sequestrants when are they used?

not effective alone often combined with a statin

what are the bile acid sequestrants

cholestryamine colesevelam

bile acid sequestrants are contraindicated in ____ and _____ obstruction

biliary bowel

fibrates include _____ and _______

fenofibrate gemfibrofizil

fibrates are only med which can. lower ____

triglycerides

fibrates can increase the risk for ______

gallstones

fenofibrate and gemfibrozil help to lower _____

triglyceride only med for this!!!

PCSK9 inhibitor are what meds

evoculumab alirocumab

PCSK9 injected every _____ weeks

2-4

when are PCSK9 inhibitors used

resistant hyperlipidemia, familial causes

what is metabolic syndrome

group of conditions which increase risk for cvd, organ damage, and diabetes,

metabolic syndrome requires the diagnosis of ____ of the following abdominal obesity - waist greater than __ inches men ___ in women htn bp- systolic ___ diastolic, ______ fasting blood sugar >___ triglyceride >__

>3 40, 35 >130 >80 >100 150

symptoms that occur in metabolic syndrome

fatigue nausea vomiting fatigue most do not have specific symptoms

obesity tx

lifestyle modification - diet, exercise, behavioral therapy medication GLP1 (BEST BENEFIT) surgery gastric bypass, sleeve gastreceotmy

obesity demographic

women> men obesity steadily increasing

AHA screening for dyslipidemia in those 20-39 can assess risk factor every _____ years

4-6

a 24 year old male has a smoking and family history of hyperlipidemia is this enough to screen ?

yes, accoriding to aha >1 risk factor (smoking and family hisotyr is compelling to screen in males 20-25 females 30-35 in females if high risk them screen

what drug is most powerful to lower LDL ?

statins, inhibit hmg coa reductase and also decrease LDL also have cardioprotective benefits as well

ezetimibe MOA

inhibit sterol transporter at small intestine border and thus prevent absorption of cholesterol

ezetimibe ade

increase in LFTs GI upset, diarrhea, headache

safe med to use with a pregnant pt

cholestyramine colesevelam

bile acid sequestrant MOA

large polymer which bind to bile acid and block reabsorption of bile acids, increasing fecal acid secretion

>70 diabetic _____statin

MODERATE

LDL >__ YOU WILL START STATIN

190

________ is used for treating hyperlipidemia, variety of fish at least twice a week

omega 3

HDL good range for

men is greater than 40 Women is greater than 50

When to start screening for lipids

Children is 9-11 Then again from ages 17-21

dyslipidemia Flashcards

(68 cards)