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39 Cards in this Set
- Front
- Back
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What's the most prevalent form of abnormal lipid metabolism?
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Polygenic hypercholesterolemia
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What characterizes atherogenic dyslipidemia?
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High triglycerides, low HDL, high LDL
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True or False:
Most patients with atherogenic dyslipidemia have metabolic syndrome. |
True
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How do you manange a patient with atherogenic dyslipidemia (generally)?
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Drugs to lower LDL (statins) and drugs that lower TG (Niacin, Fibrates)
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A 31 year old patient comes to see you after moving to the area. You notice his LDL is 340 and has a strong family history of premature CHD. On PE you notice he has xanthomas on his achilles tendons. What do you suspect?
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Familial Hypercholesterolemia
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True or False:
Even though lowering cholesterol in patients help prevent against some diseases, it has no effect on CHD risk because the damage has already been done. |
False: lowering cholesterol lowers CHD risk
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At what TG level can you not calculate LDL?
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>400 mg/dL
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If TG are over 400, how do you measure LDL?
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10-12 hour fast
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What should every patient with hypercholesterolemia be evaluated for?
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Secondary causes of high cholesterol: DM, hypothyroid, nephrotic syndome, obstructive liver disease, or drug-induced.
Familial Disorders Presence of CHD and CHD risk equivalents CHD risk factors |
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What are drugs that can cause high cholesterol?
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Diuretics
Accutane Beta-Blockers Glucocorticoids Cyclosporine Oral Contraceptives |
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What are some CHD and CHD risk equivalents?
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Angina, MI, Angioplasty, and Coronary bypass
Stroke history, TIAs, PAD, AAA, and DM. |
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What are the positive risk factors for CHD?
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Male > 45 yrs old
Female > 55 yrs old Family history of MI or CHD Cigarette smoking HTN: > 140/90 Low HDL: < 40 |
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What is the weight loss goal for TLC?
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10% reduction of body weight in 6 months
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What affect does exercise have on the lipid profile?
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Reduce TG
Raise HDL |
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What is the only drug that can lower Lpa?
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Niacin
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What are some examples of bile acid sequestrants?
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Colestipol, Cholestyramine, Colesevelam
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Bile acid sequestrants have what affect on lipids?
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Reduces LDL by 15-18%
Can raise TG levels |
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How are bile acid sequestrants best used?
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As an additive with other therapies
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Zetia is an example of what kind of lipid lowering agent?
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Cholesterol absorption inhibitors
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What affect on the lipid profile does Zetia have?
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Reduces LDL 18-22%
Little or no effect on TG or HDL |
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How is Zetia best used?
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As an additive with Statins
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When would you not use bile acid sequestrants?
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if the patient has high TG because they can raise TG
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What are the affects of Niacin on the lipid profile?
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Lowers LDL
Lowers TG Raises HDL |
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What lipid lowering agent has the best affect on TG?
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Niacin
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Flushing, hepatotoxicity, fatigue, and hyperuricemia are side effects of what drug?
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Niacin
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What is the drug of choice to lower cholesterol and reduce CHD risk?
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Statins
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What are the effects of statins on the lipid profile?
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Lowers LDL
Lowers TG Raises HDL |
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List the statins in descending order of LDL lowering activity.
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Rosuvastatin (Crestor)
Atorvastatin (Lipitor) Simvastatin (Zocor) Lovastatin (Mevacor) |
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When should you take statins?
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in the evening
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Myalgias are the most important side effect of what drug?
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Statins
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Why shouldn't a statin and gemfibrozil (Lopid) be taken together?
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it increases the risk for myositis
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What are three drug interactions with lovastatin, simvastatin, and atorvastatin?
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Macrolides
CCB Azole Antifungals |
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What affect might rosuvastatin have on coumadin?
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it may prolong PT
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Fish oils have what affect on the lipid profile?
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Lower TG
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What are some examples of fibric acid derivatives?
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Gemfibrozil (Lopid) and Fenofibrate (TriCor)
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What affect do fibric acid derivatives have on the lipid profile?
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Lower TG
Raise HDL |
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If a patient has TG >1000, what is the best treatment?
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Fibrate and Niacin
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What is the best combination therapy?
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Statin-Zetia
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If a patient has isolated low HDL, what is the best treatment?
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Statin, Niacin, or statin-niacin combination
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