Dyslipidemia and Stroke Flashcards Preview

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Flashcards in Dyslipidemia and Stroke Deck (28):
1

In general, when should anti lipids be started?

7.5% risk or greater of CV event

2

What meds can cause dyslipidemia

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

3

What diseases can cause dyslipidemia?

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

4

Exam findings for dyslipidemia

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

5

Labs for dyslipidemia?

Renal, LFTs, CK, TSH,

6

When to start high intensity treatment for dyslipidemia?

1. Patients with atherosclerotic CV disease
2. patients with LDL > 190

7

When to start low intensity treatment for dyslipidemia?

1. DM with LDL 70-189
2. No CVD or DM, but 10 year risk of 7.5% or greater

8

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

-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

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

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

10

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

-Ezetimibe
-Decreaes LDL
-Monitor warfarin
-May increases LFTs x3

11

Omega 3 Fatty Acids

Decrease triglycerides

12

What might Niacin do, and contraindications?

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

13

Risk factors for Stroke?

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

14

Assessment for Stroke?

Pregnancy, carotid bruit, heart sounds, valvular disorder

15

Differential diagnosis of stroke?

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

16

When do you treat carotid stenosis?

If there is > 50% blockage

17

What meds should patients be on after ischemic stroke?

Aspirin and plavix, smoking cessation

18

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

CRP >2
CT Calcium Score > 300
Homocysteine level

19

Who do you refer familial hypercholesterolemia to?

Endocrinologist

20

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

Pravastatin, it's water soluble

21

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

Initial CK

22

How much does high and low intensity drop statins?

High = >50%
Low= 30%

23

Side effects of statins? (x3)

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

24

Metabolic syndrome, need 3 out of the 5

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

25

When do you start screening for hyperlipidemia?

20 years old

26

When do you treat hypertriglyceridemia? And why?

When they are over 500, to prevent pancreatitis

27

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

Parities from cholestatic disease or biliary obstruction

28

What medication should you give with statins and why?

Gemfibrozil- may increase risk for rhabomyolisis