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52 Cards in this Set

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Definition of dyslipidemia
elevation of one or more of cholesterol (TC and/or LDL), elevated triglycerides (TG), low HDL, or some combination
Purpose of chylomicrons
carry dietary lipid
Calculation for VLDL
TG/5
VLDL carries most of the TG in the _________ state
fasting
"bad cholesterol"
LDL
_______ transports the majority (60%-70%) of total cholesterol from the liver to the peripheral cells
LDL
"good cholesterol"
HDL
__________ transport TC from peripheral cells back to the liver by reverse cholesterol transport
HDL
IDL measured as part of _______
LDL
______ has strong correlation with heart disease
LDL
Core of lipoprotein contains:
TG and CE
Protein that make VLDL and LDL from HDL
CETP
apoA-I is in _______
HDL
Inhibit CETP will increase ______
HDL
What causes cardiovascular event?
thrombosis
Put these in order of endothelial dysfunction:

a. Fatty streak
b. complicated lesion/rupture
c. atheroma
d. intermediate lesion
e. fibrous plaque
f. foam cellsd
f, a, d, c, e, b
Most common CV death is ______
Coronary heart disease, then stroke
1% decrease in LDL = ___% of CHD
1%
1% increase in HDL = ___ decrease CHD
2%
T/F: increased risk of stroke correlated with elevated TC
True
T/F: statins may reduce stroke
True; statins are approved for stroke prevention
Most common type of familial dyslipidemia.
polygenic hypercholesterolemia IIa
Secondary dyslipidemia
hypothyroidism: high TG, TC
Obstructive liver disease
chronic renal failure: high TG, TC
Nephrotic syndrome
Alcohol use: high TG, HDL
Drugs that increase LDL and decrease HDL
progestins, anabolic steroids, corticosteroids
Drugs that increase TG
thiazide diuretics, BB, oral estrogens
what is xanthomas?
cholesterol nodules in tissue
Preferred option to screen for lipid.
fasting TC, LDL, HDL, and TG every 5 years once > 20 years of age
Proceed to complete lipoprotein profile if
TC > 200 mg/dL or HDL < 40 mg/dL
Friedwald Equation
LDL = Total - HDL - VLDL

VLDL=TG/5, where TG < 400 mg/dL
TC desirable #
borderline high #
high #
<200
200-239
>240
LDL optimal #
Near optimal
borderline high
high
very high
<100
100-129
130-159
160-189
>190
HDL low #
high #
<40
>60
TG desirable #
borderline high
high
very high
<150
150-199
200-499
>500
Advanced testing are:
NMR lipoprofile: look at particle sizes and density
VAP testing: breaks down HDL and LDL into different density levels.
What are the CHD risk equivalents?
Diabetes
Peripheral Arterial Disease (PAD, PVD)
Abdominal Aortic Aneurysm (AAA)
Symptomatic carotid artery disease
Multiple risk factors that confer 10-year risk for CHD > 20%
If pt has CHD or CHD risk equivalents 10-year risk > 20%, what is pt LDL goal?
<100 mg/dL; optional <70 mg/dL
pt with 2+ risk factors, LDL goal =
<130
pt with 0-1 risk factor, LDL goal =
<160
What are the risk factors that modify LDL goals?
1. age (m > 45; w > 55)
2. family hx of premature CHD (m < 55 yo; w < 65 yo)
3. smoker
4. HTN (bp>140/90; or taking anti-HTN)
5. low HDL-C (<40 mg/dL)
Framingham score does not include which risk factor?
Family history
Framingham risk calculation based on:
gender, age, smoke, SBP, TC, HDL
Life-habit risk factors:
obesity BMI > 30
Physical inactivity
atherogenic diet
Does life-habit risk factors change LDL goal?
no
Emerging risk factors are:
lipoprotein (a)
Proinflammatory factors
C-reactive protein
Impaired fasting glucose
Subclinical atherosclerosis
Prothrombotic factors
Proinflammatory factors
C-reactive protein
Impaired fasting glucose
Subclinical atherosclerosis
Prothrombotic factors
Metabolic syndrome risk factors are:
abdominal obesity m>40 in; w>35 in
TG > 150
HDL, men<40, women < 50
BP >130/85
Fasting glucose >100 mg/dL
non HDL-C =
TC - HDL
when pt TG>200 mg/dL
Primary goal is:
secondary goal is:
primary: LDL
secondary: non-HDL
if pt TG > 500 mg/dL, what is primary goal?
reduce TG
non-HDL goal for CHD risk equivalent; 2+ risk factor; <2 risk factors
<130
<160
<190
if TG are elevated, HDL is low, which drugs should be considered?
fibrate or niacin with LDL lowering drug (statins)
when is non-HDL a necessary secondary target of therapy?
if TG > 200 mg/dL
What % reduction in LDL is sufficient for LDL lowering therapy?
30 -40%