Dyslipidemia and Stroke Flashcards Preview

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Flashcards in Dyslipidemia and Stroke Deck (28)
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1
Q

In general, when should anti lipids be started?

A

7.5% risk or greater of CV event

2
Q

What meds can cause dyslipidemia

A

Steroids, thiazide diuretics, estrogen, anabolic steroids, cigarette smoking, alcohol

3
Q

What diseases can cause dyslipidemia?

A

DM, hypothyroidism, nephrotic syndrome, ESRD, Cushing’s syndrome

4
Q

Exam findings for dyslipidemia

A

Corneal arcus, xanthelasmas around eyes and tendons. Also check bruit

5
Q

Labs for dyslipidemia?

A

Renal, LFTs, CK, TSH,

6
Q

When to start high intensity treatment for dyslipidemia?

A
  1. Patients with atherosclerotic CV disease

2. patients with LDL > 190

7
Q

When to start low intensity treatment for dyslipidemia?

A
  1. DM with LDL 70-189

2. No CVD or DM, but 10 year risk of 7.5% or greater

8
Q

Statins: intensities, side effects, and caution and other medication

A
  • Atorvastatin 40-80, low 10-20
  • Rouvastatin (half of Atorvastatin dose)
  • Decreases LDL, Trigly, increases HDL
  • Myositis and LFTs
  • Don’t use with gemfibrozil
9
Q

Bile Acid Sequesterants- names, affect on lipids, and contraindications

A
  • (chols)-Cholesytyramine, colesevelam
  • Decrease LDL, incr HDL, Marginal effect on triglycerides
  • Don’t use if trig >300
  • Don’t give with other medications
10
Q

Cholesterol absorption Inhibitor: name, action/result, drugs to monitor, and adverse effects

A
  • Ezetimibe
  • Decreaes LDL
  • Monitor warfarin
  • May increases LFTs x3
11
Q

Omega 3 Fatty Acids

A

Decrease triglycerides

12
Q

What might Niacin do, and contraindications?

A
  • Hyperglycemia (Ok for A1C <7), hyperuricemia
  • flushing- give ASA
  • Contraindicated in PUD, GI disease, liver disease
13
Q

Risk factors for Stroke?

A

Stress, no physical activity, high homocysteine, carotid artery stenosis, TIA, anterior MI, long term oral anticoagulants, aortic wall plaques

14
Q

Assessment for Stroke?

A

Pregnancy, carotid bruit, heart sounds, valvular disorder

15
Q

Differential diagnosis of stroke?

A

SAH, brain absess, pseudo tumor cerebri, carotid artery dissection, encephalitis, TIA, encephalitis, syncope, intoxication, conversion disorder, migraine, bell’s palsy

16
Q

When do you treat carotid stenosis?

A

If there is > 50% blockage

17
Q

What meds should patients be on after ischemic stroke?

A

Aspirin and plavix, smoking cessation

18
Q

What additional labs can help with decisions on when to start lipid therapy?

A

CRP >2
CT Calcium Score > 300
Homocysteine level

19
Q

Who do you refer familial hypercholesterolemia to?

A

Endocrinologist

20
Q

What medication is a good alternative for patients who can’t handle high dose statins?

A

Pravastatin, it’s water soluble

21
Q

What lab to not forget when starting someone on a statin?

A

Initial CK

22
Q

How much does high and low intensity drop statins?

A
High = >50%
Low= 30%
23
Q

Side effects of statins? (x3)

A

Memory loss, increase risk of DM, myopathy and hepatic injury.

24
Q

Metabolic syndrome, need 3 out of the 5

A
  1. Abdominal Obesity (men 40, women 35), 2.Tryglicerides >150
  2. Low HDL
  3. Hypertension- 135/85;
  4. Fasting glucose >110
25
Q

When do you start screening for hyperlipidemia?

A

20 years old

26
Q

When do you treat hypertriglyceridemia? And why?

A

When they are over 500, to prevent pancreatitis

27
Q

What else can you use bile acid sequesterants for besides hyperlipidemia?

A

Parities from cholestatic disease or biliary obstruction

28
Q

What medication should you give with statins and why?

A

Gemfibrozil- may increase risk for rhabomyolisis