Hyperlipidemia

Question 1

Hyperlipidemia vs hypercholesterolemia

Answer 1

hyperlipidemia=high levels of LDL or triglycerides

hypercholesterolemia=high levels of cholesterol

Question 2

secondary dyslipidemia (levels are either high or low) lab work up

Answer 2

UA (looking for metabolic syndrome), TSH, LFTs, A1C, FBS

Question 3

HDL over what is a negative risk factor for CHD

Answer 3

60

Question 4

Are triglycerides an independent risk factor for CHD?

Answer 4

no

Question 5

Premature arches cornealis

Answer 5

a deposit of phospholipid and cholesterol in the peripheral cornea. hazy white, grey, or blue opaque ring

Question 6

Lipemia retinalis

Answer 6

abnormal appearance of the retinal arteries and veins caused by increased triglycerides

Question 7

normal triglyceride level

Answer 7

<150

Question 8

desirable total cholesterol level

Answer 8

<200

Question 9

Optimal LDL level

Answer 9

<100

Question 10

when do you do a follow up appointment after a statin is started?

Answer 10

6-8 weeks

Question 11

Bile Sequestrants and Fibrates work best on what?

Answer 11

triglycerides

Question 12

Fibrate examples

Answer 12

Gemfibrozil (Lopid), Fenofibrate, Clofibrate

Question 13

Gemfibrozil (Lopid), Fenofibrate, Clofibrate are examples are what

Answer 13

Fibrates

Question 14

What medications do you need to be careful with when giving a fibrate?

Answer 14

coumadin and oral hypoglycemic agents for DM

Question 15

If CK levels are elevated and patient is experiencing muscle weakness, what 3 things could you do?

Answer 15

Change to something different OR
Change to different Statin OR
Start Statin at a lower dose

Question 16

What is the ASCVD risk factor for a diabetic, CKD or other people with 2 or more risk factors?

Answer 16

high

Question 17

is ASCVD screening the same for women and men?

Answer 17

yes

Question 18

If an older adult (65 years or older) has a risk factor of 0-1 how often should you screen for dyslipidemia?

Answer 18

annually

Question 19

when do you start evaluating young adults for dyslipidemia and how often

Answer 19

at 20 years old and every 5 years

Question 20

middle aged adults (45-65) with no ASCVD risk factors should be screened for dyslipidemia how often?

Answer 20

every 1-2 years

Question 21

Simon Broome Register Diagnostic Criteria
Dutch Lipid Clinic Network Diagnostic Criteria
U.S. MEDPED

Answer 21

3 clinical diagnostic tools used for Familial Hypercholesterolemia diagnosis

Question 22

What criteria does this fit?

Premature ASCVD, fasting LDL-C >190 mg/dL, the presence of tendon xanthomas, full corneal arcus in individuals <40 years of age, or a family history of high cholesterol and/or premature ASCVD1

Answer 22

Factors that lead to an FH diagnosis include

Question 23

what does alcohol affect?

Answer 23

triglycerides

Question 24

a very high triglyceride level and low HDL signals what?

Answer 24

insulin resistance

Question 25

a low HDL

Answer 25

<40

Question 26

An increased total cholesterol and LDL levels could be caused by what secondary causes?

Answer 26

- Hypothyroid - Nephrosis (protein in urine) - Dysgammaglobulinemia (systemic lupus erythematosus, multiple myeloma) - Progestin or anabolic steroid treatment, - Diseases of the liver due to abnormal lipoproteins - Protease inhibitors for treatment of HIV infection

Question 27

AN increase in triglycerides and VLDL could be caused by what secondary causes?

Answer 27

*   Chronic renal failure *   T2DM *   Obesity *   Excessive alcohol intake *   Hypothyroidism *   Antihypertensive medications (thiazide diuretics and b-adrenergic blocking agents)  *   Corticosteroid therapy *   Orally administered estrogens, oral contraceptives, pregnancy *   Protease inhibitors for treatment of HIV infection

Question 28

PCSK9 inhibition example

Answer 28

Repatho

Question 29

No ASCVD risk factors is what risk and what should their LDL be?

Answer 29

low; <130

Question 30

2 or fewer ASCVD risk factors and a calculated 10-year risk of less than 10% is what risk and what should LDL be?

Answer 30

moderate, <100

Question 31

leading cause of mortality in women?

Answer 31

ASCVD

Question 32

Can physical activity be broken up throughout the day in 10 minute sessions?

Answer 32

yes

Question 33

what constitutes as physical activity?

Answer 33

brisk walking, riding a stationary bike, water aerobics, cleaning/scrubbing, mowing the lawn, and sporting activities (Need to lose at least 200cal/day

Question 34

recommended diet

Answer 34

reduced calorie diet with fruits, veggies, grains, fish and lean meats

Question 35

when are omega 3 fish oils good to use? and what are examples?

Answer 35

triglycerides >500, Vascepa and Lovaza

Question 36

Question, Welchol, Cholestyramine are example of?

Answer 36

bile sequestrants

Question 37

what are bile sequestrants good for? and what bad thing might they increase?

Answer 37

lowering LDL and increasing HDL, may increase TG

Question 38

bile acid sequestrants side effects

Answer 38

constipation, diarrhea, bloating

Question 39

bile acid sequestrants action

Answer 39

bind to bile acids (which contains cholesterol) in the intestine and prevent their reabsorption into the body

Question 40

when are PCSK9 inhibitors used?

Answer 40

in combo with Statins or with a person who can't tolerate a statin

Question 41

cholesterol absorption inhibitor example

Answer 41

Zetia (Ezetimibe)

Question 42

Zetia (Ezetimibe) is an example of what?

Answer 42

Cholesterol absorption inhibitor

Question 43

rosuvastatin is also called?

Answer 43

Crestor

Question 44

Simvastatin is also called?

Answer 44

zocor

Question 45

Statins have a potential drug interaction with which drugs?

Answer 45

CYP450 3A4 inhibitors, cyclosporine, warfarin, and protease inhibitors (HIV meds)

Question 46

what disease is at increase risk for developing while on statins?

Answer 46

diabetes

Question 47

pravastatin is also called

Answer 47

pravachol

Question 48

Atorvastatin is also called?

Answer 48

Lipitor

Question 49

Alirocumab and Evolocumab are examples of what?

Answer 49

PCSK9 inhibitors

Question 50

PCSK9 inhibitors adverse reactions

Answer 50

influenza, nasopharyngitis

Question 51

PCSK9 inhibitors are given how often?

Answer 51

SQ q 2 weeks

Question 52

If GFR is <15 what should you do with vibrate medication?

Answer 52

stop it

Question 53

If GFR is 15-60 what should you do with vibrate medication?

Answer 53

cut dose in half

Question 54

Fibrates can improve what diabetic problem?

Answer 54

diabetic retinopathy

Question 55

Fibrates can increase what? what are they mainly good for?

Answer 55

can increase LDL, good for TG and HDL

Question 56

Fibrates adverse reactions

Answer 56

GI symptoms, possible cholelithiasis

Question 57

Fibrates can interact with what other medications?

Answer 57

anticoagulants

Question 58

Bile Acid Sequestrants may reduce the absorption of what?

Answer 58

folic acid and fat-soluble vitamins such as vitamins A, D, and K

Question 59

Vascepa and Lovaza is an example of what

Answer 59

omega 3 fatty acid

Question 60

Omega 3 fatty acid drug interactions

Answer 60

coagulation meds. They will prolong bleeding time, also increase ALT

Question 61

when a patient is on a stable lipid lowering medication how often should you check lipids?

Answer 61

every 6 to 12 months

Question 62

what should be measured before and 3 months after starting niacin or a fibrate?

Answer 62

liver enzymes

Question 63

When are Creatine kinase levels drawn

Answer 63

when a patient experiences myalgias or muscle weakness

Question 64

when do you check lipids when starting a new cholesterol med?

Answer 64

6-8 weeks