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15 Cards in this Set

  • Front
  • Back
A patient has a total cholesterol of 180, a HDL of 34 and triglycerides of 80. What is the LDL level?
E: 130; LDL = TC - HDL - Trig/5
A: 130.
Familial hypercholesterolemia is an autosomal dominant disorder. True/False?
E: FH is an autosomal dominant disorder due to a mutation in the LDL receptor (causing a deficient or defective receptor) that leads to altered LDL catabolism and increased cholesterol synthesis. Approximately 1/500 people are heterozygous carriers of a mutation and 1/1,000,000 are homozygous for the disorder. Such people have much higher rates of premature atherosclerosis and can have myocardial infarctions at a very young age. Physical exam often reveals tendinous xanthomas (cholesterol deposition in the extensor tendons) and corneal arcus. Management is aimed at aggressive LDL-lowering to reduce cardiovascular risk.
What complications can occur in patients with chylomicronemia syndrome?
E: Physical manifestations of this syndrome include lipemia retinalis, eruptive xanthomas, and hepatomegaly. Patients are at increased risk of developing pancreatitis.
A: Hepatomegaly, pancreatitis
At what age should you start screening for dyslipidemia?
E: Current recommendations for screening and treatment are based on the National Cholesterol Education Program guidelines that were last revised in 2001. It is recommended that adults 20 years or older have a screening fasting lipid profile obtained every 5 years (more often if they are at high risk). Treatment is based on determining the patient's LDL cholesterol (LDL-c) goal. This goal is modified by cardiovascular risk factors (independent of LDL levels).
A: 20
What are the risk factors for coronary artery disease?
E: * Age: male ≥ 45 years, female ≥ 55 years
* Family history: coronary heart disease (CHD) in a male first-degree relative < 55 years or female first-degree relative < 65 years
* Current cigarette smoking
* Hypertension (≥ 140/90 mmHg or on antihypertensive medications)
* Low HDL cholesterol: < 40 mg/dL (Note: High HDL-c is a negative risk factor; if the patient has a level > 60 mg/dL, subtract one risk factor.)
What are the three LDL-c goals?
E: Those with CHD or CHD equivalent, the LDL goal is 100; for those with 2 risk factors it is 130; for those with 0-1 risk factors it is 160.
A: 100,130,160
For patients with CHD equivalent risk, when will you consider medication?
E: TLC is started at LDL of 100 and medications are considered for LDL greater than 130.
For patients with 2 CAD risk factors, when will you consider medication?
E: TLC is started at LDL of 130 and medications are considered for LDL greater than 160.
For patients with 0-1 CAD risk factors, when will you consider medication?
E: TLC is started at LDL of 160 and medications are considered for LDL greater than 190.
According to a recent update of ATP III, what is the LDL goal for a very high risk patient?
E: 70. A recent update to the NCEP ATPIII Guidelines indicated that an optional LDL goal for very high risk patients could be < 70 mg/dL. A very high risk person was defined as a patient with known cardiovascular disease and multiple and/or uncontrolled risk factors, multiple risk factors of the metabolic syndrome or an acute coronary syndrome.
A: 70
Which group of drugs are the treatment of choice for hypertriglyceridemia?
E: Fibrates: clofibrate, fenofibrate and gemfibrozil.
A: fibrate
Which drug inhibits the absorption of cholesterol from the gut?
E: Ezetimibe
A: Ezetim
Which group of drugs does colesevelam belong to?
E: Bile acid resin
A: Bile acid resin
What are the side-effects of statins?
E: Overall well-tolerated
↑LFTs, Rhabdomyolysis, Myositis
Drug interactions
A: myositis, rhabdo, LFT, interac
What are the side-effects of fibrates?
E: Cholelithiasis, myopathy, drug interactions
A:(gall)|(chole), myop, inter