Lipids and cardiovascular disease Flashcards Preview

T IoD biochemistry > Lipids and cardiovascular disease > Flashcards

Flashcards in Lipids and cardiovascular disease Deck (31):
1

what are modifiable risk factors for heart disease?

- smoking
- diet
- BMI
- exercise
cholesterol
-BP

2

what are non modifiable risk factors for heart disease?

- family history
- sex
- age
- ethnicity

3

what other illnesses are linked with hyperlipidaemia?

- MI
-acute pancreatitis
- xanthelasma

4

what are clinical signs of hyperlipidaemia?

Tendon xanothoma
- corneal arcus
- thickening of the achilles

5

what are causes of secondary hyperlipidaemia?

Diabetes
Hypothyroidism
Renal Disease
Liver disease
Alcohol

6

what baseline investigations should be done on all patients with lipid disorders?

- lipid profile
-U and E
- LFT
-ggT
-fasting glucose
-TFT
- urine dipstick

7

what is the cut off for a specialist referral due to hyperlipidaemia?

TC>9 or non HDL>7,5 even if there is no family history

8

what is the defect in autosomal dominant hypercholesterolaemia?

defect of LDL APO B receptor gene
Less cholesterol efflux

9

what is PCSK9?

A serine protease

10

what is the effect of PCSK9?

When they bind to LDL it causes both of their degradations

11

why are PCSK9 inhibitors a potential treatment for hyperlipidaemia?

PCSK9 causes destruction of LDL receptors meaning less clearance
when inhibited more LDL receptors can be recycled to the cell surface to take up more LDL cholesterol

12

what is the role of LDLRAP1?

mediates the position of the LDL receptors to the coated pits

13

what is remnant disease?

There is accumulation of LDL remnant particles
Will have high lipids and triglycerides

14

what is the defect in remnant disease?

In apoE2

15

how is hyperlipidaemia classified?

Depending on triglycerides and cholesterol levels

16

what is type IIA?

Just very high cholesterol
Can be familial hypercholesterolaemia

17

what is type IIB?

Very high cholesterol
slightly high triglycerides
can be familial combined hyperlipidaemia

18

what is type III?

High cholesterol and high triglcyrides
Increased in IDL

19

what is type IV?

Very high triglyceride and cholesterol
Often secondary

20

what is type I/V?

Very high triglycerides with a slightly raised cholesterol

21

what is the NICE specified risk scoring system for cardiovascular disease?

QRISK2

22

What does QRISK2 take into account?

- age
- gender
- ethnicity
- smoking
- diabetes
- family history
- AF
- medications
- RA

23

what lipoproteins does the Apo A1 test measure?

HDL

24

what lipoproteins does the Apo B100 test measure?

LDL
IDL
VLDL

25

Values above which number for the Lp test are associated with increase CVD risk?

300mg/l

26

values above which score on CRP are associated with increased CRP risk?

3

27

what lifestyle advice can be given for hyperlipidaemia?

- eat a cardioprotective diet
- physical activity
- weight management
- alcohol
-smoking cessatation

28

how does ezetimibe work?

Inhibits gut absorption of cholesterol and inhibits VPCILI a lipid transporter

29

what is the criteria for diagnosing an acute MI?

Two of:
- clinical features like chest pain
- ECG changes
- cardiac enzyme changes

30

Other than a heart attack what else can cause raised troponin?

- Primary ischaemic cardiac injury due to an acute coronary syndrome mainly a ruptured plaque

Secondary ischaemic cardiac injury

Non ischaemic cardiac injury

31

what are causes of non ischaemic cardiac injury?

- myocarditis causes such as viral
- cardiac trauma
- inflammation
- auto immune
- drugs