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Flashcards in Dyslipidimia Deck (22):
1

Classification of Dyslipidemia

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

2

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

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

3

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

statins and
n-3 fatty acids

4

Major risk factors for CAD include:
1
2

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

5

Risk increases with increasing cholesterol levels
(90% if >_______

7.8 mmol/L

6

TG levels >10 mmol/L increases risk of
________

pancreatitis

7

10% reduction of total cholesterol gives _______
reduction in CAD after 3 years

20%

8

Common causes of secondary
dyslipidaemia

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

9

Recommended treatment goals
• Total cholesterol ________
• LDL-C _________*
• TG _______
• HDL-C ≥ ______
• non-HDL-C <2.5 mmol/L

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

10

Dyslip Treatment should commence with a_____

statin.

11

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

ezetimibe,bile acid binding resin or nicotinic acid.

12

SE of statins

GIT side effects, myalgia,
abnormal liver function (uncommon

13

In statin Tx, repeat LFTs after

4–8 weeks, then every 6
weeks for 6 months

14

Combination: ezetimibe + statin (especially if
_________

cholesterol below target)

15

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

cholestyramine

16

_________ consider if above drugs not tolerated

Fibrates:

17

Adverse effects of nicotinic acid

flushing, gastric irritation,
gout

18

Mx of Resistant LDL-C elevation

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

19

Moderate to severe (isolated or
predominant) TG elevation

Fibrate:

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

20

Massive hypertriglyceridaemia
(TG) 10 mmol/L:

fibrate plus fish oil plus (if necessary) nicotinic acid

21

Mixed hyperlipidaemia (↑ TG + ↑ LDL-C)

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

statin

fibrate

22

Statin + gemfibrozil increases risk of
______and requires specialised supervision

myopathy