Hyperlipidemia

Question 1

US adults with total cholesterol over 200

Answer 1

100mil

Question 2

percent children under 15 and pts 21-39 with fatty streaks

Answer 2

50, 85

Question 3

vulnerable plaque

Answer 3

large lipid core, thin fibrous cap, macrophages interacting with thrombus

Question 4

stable plaque

Answer 4

reduced lipid core, thick fibrous cap, increased smooth muscle

Question 5

screening frequency ACA/AHA v USPSTF

Answer 5

ACA: 4-6yrs, USPSTF: 5yrs (lipids and ASCVD risk)

Question 6

reducing sat. fat to 5-6% of diet can lower LDL by

Answer 6

11-13mg/dL, 11%

Question 7

pts w/clinical ASCVD

Answer 7

high intensity statin (40 atorva)

Question 8

pts w/LDL>190

Answer 8

high intensity statin (40 atorva) grade B

Question 9

pts age 40-75 w/DM and LDL 70-189

Answer 9

get 10y ASCVD risk! moderate if under 7.5, high if over

Question 10

moderate dose statin

Answer 10

atorva 10, simva 20-40, prava 40, lova 40

Question 11

pts w/o CVD or DM, LDL 70-189 and CVD over 7.5

Answer 11

mod to high dose statin

Question 12

prevalence of myopathy in statins

Answer 12

1-20% (lower w/CoQ10?)

Question 13

prevalence of rhabdo in statins

Answer 13

under .06%

Question 14

prevalence of liver fox

Answer 14

under 1.5 in 5 year use

Question 15

ALT cutoff for statins

Answer 15

increase over 3x normal

Question 16

use statins despite ICH

Answer 16

if ASCVD is over 40%

Question 17

causes of very high triglycerides

Answer 17

alcohol, uncontrolled DM, hyperalbuminuria

Question 18

Americans w/cholesterol over 240

Answer 18

34.5mil

Question 19

percent over 18 w/lipid screening in 2008

Answer 19

74.6 (Healthy People wants 82.1)

Question 20

CHD and CVD risk in latinos

Answer 20

20% less than whites, but don’t treat differently

Question 21

screen for HLD at 20

Answer 21

if pt has incrased risk for coronary heart dz

Question 22

high triglycerides for metabolic syndrome

Answer 22

over 150

Question 23

low HDL for metabolic syndrome

Answer 23

under 40 in men, 50 in women

Question 24

hypertension for metabolic syndrome

Answer 24

130/85

Question 25

high fasting glucose for metabolic syndrome

Answer 25

over 110

Question 26

dx metabolic syndrome

Answer 26

3 of 5: waist, high triglycerides, low LDL, high BP, high fasting glucose

Question 27

substituting low fiber carbohydrates for saturated fatty acids

Answer 27

decrease HDL and increase triglycerides!

Question 28

percent of US adults with triglycerides over 150

Answer 28

30%

Question 29

lower triglycerides: wt loss (5-10%)

Answer 29

20%

Question 30

lower triglycerides: mediterrean diet (v. low fat)

Answer 30

10-15%

Question 31

lower triglycerides: add marine derived PUFA (EPA/DHA)

Answer 31

5-10% (adding omega has not been shown to reduce CV events in patients with high trig.

Question 32

lower triglycerides: decrease carbs, add 1% PUFA

Answer 32

1-2%

Question 33

lower triglycerides: eliminate trans fats, and 1% PUFA

Answer 33

1%

Question 34

high dose statins lower LDL

Answer 34

more than 50%

Question 35

low dose statins lower LDL

Answer 35

less than 30%

Question 36

low vit D and statin

Answer 36

may increase adverse effects

Question 37

2013 ACC/AHA recommends what dose statin in pt over 75 with clinical ASCVD

Answer 37

moderate intensity (E, expert opinion)