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Flashcards in Risk (Public Health) Deck (35):
1

Which lipoproteins are good and which are bad?

HDL are good (protective against atherosclerosis) and LDL are bad

2

Which lipoproteins are good and which are bad?

HDL are good (protective against atherosclerosis) and LDL are bad

3

What are the clinical features of high cholesterol?

- Xangthelasma (eyelids)
- Tendon xanthomas
- Tuberous xanthomas
- Eruptive xanthomas

4

What is the defining level for CVS risk for triglycerides?

>1.7 mmol/l

5

What is the defining level for CVS risk for HDL-C?

6

What is the defining level for CVS risk for Fasting glucose??

>5.6 mmol/l

7

Which cholesterol, which component is the primary target to prevent CHD?

LDL

8

What do statins reduce?

Total cholesterol and LDL cholesterol

9

What are the 5 kinds of lipoproteins?

Chylomicrons, VLDL, IDL, LDL and HDL

10

Where are chylomicrons synthesised and what is their function?

In the gut after a fatty meal. They transport dietary triglyceride from the gut to the sites of use and storage

11

How are IDL made and what is their function?

Formed during the breakdown of VLDL and chylomicrons. They are involved in the recycling of cholesterol by the liver as well as formation of LDL in the blood.

12

What is the defining level for CVS risk for triglycerides?

>1.7 mmol/l

13

What is the defining level for CVS risk for HDL-C?

14

What is the defining level for CVS risk for Fasting glucose??

>5.6 mmol/l

15

Which cholesterol, which component is the primary target to prevent CHD?

LDL

16

What do statins reduce?

Total cholesterol and LDL cholesterol

17

What are the 5 kinds of lipoproteins?

Chylomicrons, VLDL, IDL, LDL and HDL

18

Where are chylomicrons synthesised and what is their function?

In the gut after a fatty meal. They transport dietary triglyceride from the gut to the sites of use and storage

19

Where are VLDL made and what is their function?

Made in the liver. They are the main carriers of endogenous triglycerides and cholesterol to sites for use or storage. They are also involved in the synthesis of LDL and HDL,

20

How are IDL made and what is their functions?

Formed during the breakdown of VLDL and chylomicrons. They are involved in the recycling of cholesterol by the liver as well as formation of LDL in the blood.

21

How are LDL made and what is their function?

Made from IDL. They are the main carriers of cholesterol

22

What is the function of HDL?

They return about 20–30% of cholesterol in the blood to the liver from peripheral tissue for excretion, and therefore have a protective role.

23

Which lipoproteins are implicated in atherosclerosis?

VLDL, IDL and LDL

24

How do we reduce the risk of CVD?

- Reduce Risk in Environment
• Make it harder to buy things that are bad and easer to buy healthy things
- Reduce risk factors
- Identify disease early
- Optimise treatment
• Maintain a lifestyle that allows treatment to work at its best
- Minimise impact
• Cardiovascular rehab etc to ensure it doesn’t worsen or reoccur

25

Primary prevention

Stop a disease before it starts

26

Secondary prevention

Stop a disease from being as bad as it could be or re-occuring

27

Tertiary prevention

Stopping later complications from occurring

28

What are ways of making probability understandable to the patient?

1/1 - 1/10 - person within the family (very common)
1/10-1/100 - person within street (common)

29

Which score is used to estimate CVD risk?

ASSIGN score in Scotland (QRISK score in England)

30

What is the definition of high risk?

%20 chance of it happening in the next 10 years

31

What are the 2 types of plaque that can form in atherosclerosis?

• Fibro-fatty plaque - consists of a lipid core (product of dead lipid-laden foam cells) and a fibrous cap (of smooth muscle cells and connective tissue)
• Fibrous plaque – contains collagen fibres, precipitates of calcium and, occasionally, lipid-laden cells

32

What are the stages of atheroma formation? (again, I know)

1. LDL (low density lipoprotein) is up-taken into the intima of the artery and is oxidised to atherogenic oxidised LDL (OXLDL)
2. Migration of monocytes, across endothelium of the artery, into the intima where they become macrophages
3. Uptake of OXLDL by macrophages converts them to cholesterol-laden foam cells, that form a FATTY STREAK
4. Release of inflammatory mediators from cells causes division and proliferation of the smooth muscle cells, from the media, into the intima of the artery; there is also collagen deposition
5. Formation of an ATHEROMATOUS PLAQUE

33

What is a healthy rate of weight loss?

1.2kg per week

34

Which BMI is the criteria for surgery?

BMI of more than >35

35

What is the physical activity recommendations?

30 mins moderate activity at least 5 days a week (150 mins over a week) with at least 2 sessions of weight bearing a week or 75 mins of vigorous exercise over a week