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Cardiology: Exam > Hyperlipidemia > Flashcards

Hyperlipidemia Flashcards

(61 cards)

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1
Q

Increased levels of lipids in the blood, including Cholesterol and Triglycerides.

A

Hyperlipidemia

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2
Q

Makes Lipoproteins less dense.

A

Triglycerides

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3
Q

Makes Lipoproteins more dense.

A

Apoproteins

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4
Q

What is the desirable range for Total Cholesterol?

A

< 200 mg/dL

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5
Q

What is the High Risk range for Total Cholesterol?

A

240+ mg/dL

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6
Q

What is the desirable range for Triglycerides?

A

< 150 mg/dL

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7
Q

What is the High Risk range for Triglycerides?

A

200 - 499 mg/dL

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8
Q

What is the desirable range for HDL?

A

60+ mg/dL

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9
Q

What is the high risk range for HDL?

A

< 35 mg/dL

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10
Q

What is the desirable range for LDL?

A

60 - 130 mg/dL

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11
Q

What is the high risk range for LDL?

A

160 - 189 mg/dL

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12
Q

What is the desirable Cholesterol:HDL ratio?

A

4.0

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13
Q

What is the high risk Cholesterol:HDL ratio?

A

6.0

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14
Q

What lipid level remains reasonably stable overtime?

A

Total Cholesterol

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15
Q

What lipid levels tend to fluctuate more?

A

HDL + TG

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16
Q

Plaques in arterial walls of patients with atherosclerosis contain large amount of?

A

Cholesterol

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17
Q

Protein that breaks down LDL receptors.

A

Proprotein Convertase Subtilisin Kexin Type 9 (PCSK9)

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18
Q

With Familial Hypercholesterolemia, most commonly genetic defects involve what?

A

Absent or Defective LDL Receptors

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19
Q

Reducing cholesterol levels in patients without coronary heart disease.

A

Primary Prevention

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20
Q

Reducing cholesterol levels in patients with established Cardiovascular Disease.

A

Secondary Prevention

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21
Q

What are some clinical presentations of Hyperlipidemia?

A

Eruptive Xanthomas
Tendinous Xanthomas
Lipemia Retinalis

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22
Q

How is Hyperlipidemia typically diagnosed?

A

Labs

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23
Q

According to the AHA, when should you screen for Hyperlipidemia?

A

Adults 20+ years old

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24
Q

How often should you repeat screening for Hyperlipidemia?

A

Average or Low Risk = Every 5 Years
High Risk = Every Year

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25
What should individuals without Cardiovascular Disease have calculated?
10-Year-Risk of Cardiovascular Disease
26
Individuals with a LDL of what should be treated regardless of the 10-Year-Risk.
LDL > 190 mg/dL
27
What is the single best test for additional risk stratification of Cardiovascular Disease?
Coronary Artery Calcium Score (Non-contrast Cardiac CT) Takes 10-15 minutes
28
What is almost always the first-line therapy for Hyperlipidemia?
Statins
29
The 2018 AHA Multi-society Guidelines defines four groups of patients who would benefit for STATIN medications. Name those groups.
1. Atherosclerotic Cardiovascular Disease 2. LDL > 190 3. Age 40 - 75 with Diabetes + LDL ≥ 70 4. Age 40 - 75 without ASCVD or Diabetes and LDL of 70-189 + CVD Risk of ≥ 7.5%
30
Medications that inhibit the rate-limiting enzyme in the formation of cholesterol.
Statins (HMG-CoA Reductase Inhibitors)
31
What are the High Intensity Statins?
Atorvastatin (40 - 80 mg per day) Rosuvastatin (20 - 40 mg per day)
32
How much do High-Intensity Statins lower LDL by?
50%
33
How much do Moderate-Intensity Statins lower LDL by?
30 - 50%
34
What are the Second-Line medications for Hyperlipidemia?
Ezetimibe PCSK9 Inhibitors Bempedoic Acid
35
When are Second-Line medications recommended for Hyperlipidemia?
1. CVD with an LDL of 55 or 70 mg/dL 2. Familial Hypercholesterolemia with LDL > 190 and remains above 100 mg/dL treatment threshold 3. Statin Intolerance
36
What are the 8 classes of medications used to treat Hyperlipidemia?
Statins Ezetimibe PCSK9 Inhibitors Omega-3 Fatty Acids Bempedoic Acid Bile-Acid-Binding Resins Fibrates Niacin
37
What are some adverse side effects of Statins?
Muscle Aches Myositis Rhabdomyolysis Liver Disease Diabetes (10% risk if Metabolic Syndrome)
38
What Statin medication is associated with elevated risk of muscle injury or myopathy?
Simvastatin (80mg)
39
Medication that inhibits absorption of dietary and biliary cholesterol across the intestinal wall by inhibiting a cholesterol transporter.
Ezetimibe (Zetia)
40
Ezetimibe can reduce LDL by how much when used as a monotherapy?
15 - 20%
41
What is an advantage of Ezetimibe?
Side Effects are Uncommon
42
Medication that can lower LDL by 50-60% and is used to treat Familial Hypercholesterolemia and patients with CVD or High Risk of CVD and need further lowering of LDL.
PCSK9 Inhibitors (Alirocumab + Evolocumab)
43
How are PCSSK9 Inhibitors administered?
SQ every 2 - 4 weeks
44
What is an advantage PCSK9 Inhibitors?
Side Effects are Uncommon
45
What is a disadvantage of PCSK9 Inhibitors?
EXPENSIVE
46
When are PCSK9 Inhibitors recommended?
Addition to Statins with: Calcium Scores > 1000 High Risk Patients for CVD
47
Medication that targets cholesterol synthesis in the liver and can increase the risk of tendon rupture.
Bempedoic Acid
48
Consumed in the diet and are prominent feature of mediterranean-style diets.
Omega-3 Fatty Acids
49
How much can Omega-3 Fatty Acids lower triglycerides by?
30%
50
Medication that can reduce LDL but may increase TG levels.
Bile Acid-Binding Resins
51
What patients should not receive Bile-Acid-Binding-Resins?
TG > 500 mg/dL
52
What is the only medication safe for treating Hyperlipidemia during Pregnancy?
Bile-Acid-Binding Resins
53
Name some Bile Acid-Binding Resins.
Cholestyramine Colesevelam Colestipol
54
Medication that results in significant reductions in plasma triglycerides and increases HDL
Fibric Acid Derivatives (Gemfibrozil + Fenofibrate)
55
By how much can Fibric Acid Derivates reduced triglycerides by?
40%
56
What are some side effects of Fibric Acid Derivates?
Cholelithiasis Hepatitis Myositis
57
Medication that reduces production of VLDL particles.
Niacin (Nicotinic Acid)
58
Niacin can increase HDL by how much?
25-35%
59
What is the primary therapy for High Blood Triglycerides?
Dietary
60
Patients with serum triglycerides above 1000 mg/dL are at an increased risk of what?
Pancreatitis
61
When do most clinicians treat Triglyceride levels?
Above 500 mg/dL

Cardiology: Exam (5 decks)

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