Flashcards in Lipids Deck (50)
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1
If patient has VERY high triglycerides- they’re “vasculopaths”, meaning
all arteries are filled with plaques, have xanthomas, ocular effects
2
With known cardiovascular disease, _________ leads to a consistent reduction in total mortality and recurrent cardiovascular events in men and women
cholesterol lowering
3
The two main lipids in blood are ________, carried in lipoproteins.
cholesterol and triglyceride
4
Classification of lipoproteins
High-density lipoproteins (HDL)
Low-density lipoproteins (LDL)
Very-low-density lipoproteins (VLDL)
5
Chylomicrons are made in ______ and travel via the _____ into the liver and via the ________ into the circulation.
Normally completely metabolized, transferring energy from food into muscle and fat cells.
the gut
portal vein
thoracic duct
6
The plaques in the arterial walls of patients with atherosclerosis contain large amounts of cholesterol, the higher the level of______, the greater the risk of atherosclerotic heart disease
low-density lipoproteins (LDL) cholesterol
7
The higher the ________, the lower the risk of coronary heart disease (CHD)
high-density lipoproteins (HDL) cholesterol
8
High total cholesterol levels are also associated with an increased risk of
CHD (coronary heart disease)
9
Arteriosclerotic cardiovascular disease requires treatment of
high to moderate intensity statin
10
LDL-C at or over 190 requires
High intensity statin
11
Goal for diabetics is to have LDL of
less than 70
(LDL of 60 is ideal)
12
Treatment for diabetics is
moderate intensity statin, unless they have a ASCVD risk of over 7.5%, then use a high intensity statin
13
Composition of cholesterol may be more important than just total cholesterol number
-Discrepancies on how to screen (athletes vs regular people)
Equation for calculating total cholesterol:
HDL + VLDL + LDL
14
Equation for VLDL cholesterol
Triglycerides / 5
15
Equation for LDL cholesterol
Total cholesterol - HDL - (Triglycerides / 5)
16
Familial hypercholesterolemia is
rare in the homozygous state (about one per million) is a condition in which ________
the cell-surface receptors for the LDL molecule are absent or defective, resulting in unregulated synthesis of LDL
17
Familial hypercholesterolemia- Homozygotes have extremely high LDL levels present with ___________
atherosclerotic disease in childhood
18
Familial hypercholesterolemia- ***Heterozygotes have LDL concentrations _________; persons with this condition may develop _________***
twice normal
CHD in their 30s or 40s
19
Familial hyperchylomicronemia-
notes say NOT on exam
Have marked hypertriglyceridemia with recurrent pancreatitis and hepatosplenomegaly in childhood
20
Factors that increase triglycerides and total cholesterol
1. obesity (decreases HDL)
2. sedentary lifestyle (decreases HDL only)
3. DM
4. hypothyroidism
5. nephrotic syndrome
6. chronic kidney disease
7. obstructive liver disease
8. Cushing disease (corticosteroid use)
9. oral contraceptives
10. diuretics
11. beta blockers (decrease HDL)
21
Factors the decrease total cholesterol
1. cirrhosis
2. malignancy
22
Alcohol use and cholesterol
controversial (1-2 glasses of wine increases HDL)
-may increase triglycerides
23
What will increase HDL?
ACTIVITY
24
How do most patients with high cholesterol present
Most patients with high cholesterol levels have no specific symptoms or signs
Most are detected by the laboratory, either as part of the workup of a patient with cardiovascular disease or as part of a preventive screening strategy.
25
Eruptive xanthomas
-Red-yellow papules (especially on the buttocks)
-Extremely high levels of chylomicrons or VLDL particles
26
Tendinous xanthomas
-On certain tendons (achilles, patella, back of the hand)
-High LDL concentrations
-On biopsy- may look like squamous cell carcinoma
27
Lipemia retinalis
-Cream-colored blood vessels (in the fundus)
-Extremely high triglyceride levels
28
KNOW PICTURES OF XANTHOMAS
WILL BE ON EXAM
29
Who should have their lipids measured?
All patients with cardiovascular disease and diabetes should have their lipids measured (ALWAYS TRUE- EXAM)
A complete lipid profile (total cholesterol, HDL cholesterol, and triglyceride levels) after an overnight fast should be obtained
30
