Ravilya_Pediatrics_Hypercholesterolemia

Front 1

The current recommendations for serum cholesterol screening include

Back 1

The current recommendations for serum cholesterol screening include the child of a single parent with a cholesterol level greater than 240 mg/100 mL or if the history is unobtainable but there is a suspicion of hypercholesterolemia.
The recommendations to perform a serum cholesterol level and lipoprotein analysis include children with parents or grandparents with a history of coronary angioplasty or coronary artery bypass surgery, men younger than 55 years of age, women younger than 65 years of age, and children with parents or grandparents with a documented myocardial infarction among men younger than 55 years of age or women younger than 65 years of ag

Front 2

Serum cholesterol levels can be measured in the nonfasting state anytime after the age of 2 years. If serum cholesterol levels are higher than 200 mg/dL,

Back 2

lipoprotein analysis is indicated. Lipoprotein analysis
requires the patient to be fasting for 12 hours before the testing

Front 3

Low-densitylipoprotein(LDL) levels

Back 3

LDL = (total serum cholesterol) -(HDL) -(triglyceride concentration x 0.2)


Low-densitylipoprotein(LDL) levels<110 mgldL, in the presence of elevated cholesterol levels, should be repeated in 5 years.

If the LDL level is 110-129 mg/dL, a Step 1 diet is recommended.

If the LDL level is higher than 130 mgldL, then a Step 1 or Step 2 diet is recommended with consideration of medical therapy and further evaluation for secondary causes of hyperlipidemia

Front 4

Secondary causes of hyperlipidemia include

Back 4

Secondary causes of hyperlipidemia include
•
exogenous factors such as obesity, isotretinoin use, oral contraceptive use
•
endocrine or metabolic diseases including
hypothyroidism
• obstructive liver disease
• renal failure
• other factors including anorexia or a high-fat and high-cholesterol diet

Front 5

most common etiology of inherited hyperlipidemias in children

Back 5

Familial combined hyperlipidemia is the most common etiology of inherited hyperlipidemias in children. It occurs with an incidence of approximately
1 in 300 individuals and is inherited in an autosomal dominant fashion. Laboratory analysis reveals elevation of cholesterol and/or elevation of triglyceride levels.

Front 6

The etiology of familial combined
hyperlipidemia is a result of an

Back 6

The etiology of familial combined
hyperlipidemia is a result of an increased apoB-lOO production by the liver related to multiple genetic factors.

Front 7

The clinical course of familial combined
hyperlipidemia

Back 7

The clinical course is characterized by late onset of coronary artery disease and peripheral
vascular disease

Front 8

The etiology of the hypercholesterolemia

Back 8

The etiology of the hypercholesterolemia
is a result of a decrease in the number
of LDL receptors. In

Front 9

In the heterozygous form,

Back 9

In the heterozygous form, there are elevated serum cholesterol levels and a high risk of premature coronary artery disease.

Front 10

In the homozygous form, t

Back 10

In the homozygous form, there is severe hypercholesterolemia with increased risk of myocardial infarction.

Front 11

Severe hypertriglyceridemia
Mild hypertriglyceridernia

Back 11

Mild hypertriglyceridernia is associated
with obesity, glucose intolerance, hyperuricemia,
and increased alcohol intake.

Severe hypertriglyceridemia is a result of a deficiency of lipoprotein lipase and is associated with recurrent pancreatitis, hepatosplenomegaly, and xanthomas.

Front 12

In patients with hypercholesterolemia, younger than 2 years of age. tx

Back 12

In patients with hypercholesterolemia, therapy is not indicated for children younger than 2 years of age.

Front 13

txin kids >> 2 years old

Back 13

In children older than 2 years of age, initial treatment includes the Step 1 diet recommended for approximately
3 months. If the serum cholesterol level remains elevated, then a Step 2 diet is recommended for 6-12 months. If the level continues to be elevated and the child is older than 10 years of age with an LDL higher than 190 or an LDL higher than 160 and a family
history of hypercholesterolemia, then bile acid sequestrants such as cholestyramine are the first-line choice of medical therapy. In selected cases, lovastatin has been reported to be of beneficial use. However, it is currently not recommended for routine