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FAMILY MEDICINE > Hyperlipidemia > Flashcards

Flashcards in Hyperlipidemia Deck (22):
1

Mechanism of statin

b hydroxy b methylgutarl coenzyme A inhibitor (HMG-CoA) reductase inhibitor; most widely used med to lower LDL

2

Statins should be implemented in all patients with known cardiovascular disease (i.e. ASCVD; atherosclerotic cv disease) and/or with LDL greater than ____?

190

3

Statins should be implemented in patients with (what condition) and LDL cholesterol greater than _____?

DM; 70

4

Statins should be started n patients aged 40-75 with _____year CVD risk greater than or equal to ____% and LDL greater than _____

10 year; 7.5%, 70

5

Despite all these guidelines and recommendations; decision to start statin therapy should ultimately depend on....

individual risk factors

6

What tools are out there that can assess for coronary disease

QRISK, ASSIGN, QRISK2

7

Goal for HDL cholesterol

60 or greater

8

When to be concerned about low HDL

less than 40

9

Desirable, borderline, high total cholesterol

desirable 240

10

optimal, near optimal, borderline, high, very high LDL

optimal 190

GO BY 30s starting from 100!

11

secondary causes of dyslipidemia

DM, hypothyroidism, obstructive liver disease, chronic renal failure

12

how to work up secondary causes of dyslipidemia (labs)

fasting blood glucose, TSH, liver enzymes, creatinine level

13

What kinds of medications can increase cholesterol

progestins, anabolic steroids and corticosteroids

14

What are the cornerstone of all treatments of HLD

lifestyle modifications!

healthy diet, regular exercise, smoking cessation, weight control

15

Recommend a healthy diet for cholesterol management

Rich in fruits and veggies
whole-grain/high fiber foods
fish, especially oily fish at least twice a week
minimize added sugars and sugary beverages
low salt foods and low fat (especially trans-fat and saturated fats --> favor polyunsaturated fat)
adding in dietary soluble fiber may be beneficial

always offer to refer to dietician

16

In addition to lowering LDL, what added beneifts are there to statins?

reduce rates of coronary events, strokes, cardiac death, and all-cause mortality

17

If patient cannot tolerate statins, what's a good alternative?

Ezetimibe

18

Who should get evaluated for secondary causes of hyperlipidemia

Anyone with LDL over 190 or triglycerides over 500

19

Side effects of statins

myopathy, myalgia, increased liver enzymes

20

Which labs should be trended when starting statin therapy?

liver enzymes

21

contraindications to statins

active/chronic liver disease, relative contraindication with cytochrome P-450 inibitors, cyclosporine, macrolides, antifungals

22

What other treatment options are there besides statins and ezetimibe (cholesterol absorber)

nicotinic acids, bile acid sequestrants (cholestyramine), monoclonal antibodies (evolocumab), fibric acids (gemfibrozil)