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39 Cards in this Set

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