Term
| TG > 1000 can cause what skin condition? |
|
Definition
| eruptive xanthomas - red-yellow papules esp. on the buttocks |
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|
Term
| TG >2000 can cause what physical finding? |
|
Definition
| lipemia retinalis - cream colored vessels in the fundus |
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|
Term
| High LDL can cause what physical finding? |
|
Definition
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|
Term
| What is familial hypercholesterolemia? |
|
Definition
| defective or absent cell-surface LDL receptors (8X normal LDL)- usu req. liver transplant in childhood |
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|
Term
| What is familial hyperchylomicronemia? |
|
Definition
| TG >4000, recurrent pancreatitis and hepatosplenomegaly, eruptive xanthomas and lipemia retinalis |
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Term
| DMs tend to have what type of lipid abnormality? |
|
Definition
| Hypertriglyceridemia d/t elevated insulin levels |
|
|
Term
| What carries lipids from the intestines to the cells and the liver? |
|
Definition
|
|
Term
| What vitamin supplementation is used to tx dyslipidemia? |
|
Definition
| Niacin (nicotinic acid)- reduces LDL, raises HDL (best), and lowers TG |
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|
Term
| What side effects of niacin often cause poor compliance? |
|
Definition
| skin flushing and itching |
|
|
Term
| What other dietary supplement is used to tx dyslipidemia? |
|
Definition
|
|
Term
| Unlesss TG are the concern, which meds are rec. to start with when treating hyperlipidemia? |
|
Definition
|
|
Term
|
Definition
| Work in the liver to inhibit cholesterol production |
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|
Term
| What are the major side effects of statins? |
|
Definition
| muscle aches, elevated LFTs and abd pain |
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|
Term
| The long-term use of which drugs reduce the metabolism of statins? |
|
Definition
| erythromycin, cyclosporine, and azole antifungals |
|
|
Term
| How do bile acid-binding resins work? |
|
Definition
| bind bile acid in the intestines requiring the body use internal cholesterol for new bile (reduces LDL by 15-25%) |
|
|
Term
| Why are many people unable to tolerate bile acid binding resins? |
|
Definition
| GI side effects, also blocks absorption of fat soluble vitamins and other meds |
|
|
Term
| Which meds block intestinal absorption of cholesterol (dietary and biliary)? |
|
Definition
|
|
Term
| Lowering TG is the major effect of which meds? |
|
Definition
|
|
Term
| What are the side effects of fibric acid derivatives? |
|
Definition
| hepatitis, cholelithiasis, and myositis |
|
|
Term
| What are the only cholesterol lowering meds safe for use during pregnancy? |
|
Definition
| bile acid-binding resins (statins category X) |
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Term
| Name the 9 steps in ATP III. |
|
Definition
| 1) Det. lipid levels 2) Identify any CHD risk equivalents 3) Major risk factors other than LDL 4) If 2+ risk factors - assess CHD risk 5) Det. risk category 6) Therapeutic lifestyle changes 7) Drug tx if indicated 8) Identify and tx metabolic syndrome 9) Tx TG |
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|
Term
| When should you obtain a lipid panel? |
|
Definition
|
|
Term
| What are the ATP III levels of LDL cholesterol? |
|
Definition
| optimal - <100, near/above optimal - 100-129, borderline high - 130-159, high - 160-189, very high > or = 190 |
|
|
Term
| What are the levels for total cholesterol? |
|
Definition
| Desirable - <200, borderline high - 200-239, high - > or = 240 |
|
|
Term
| What are the levels for HDL cholesterol? |
|
Definition
|
|
Term
|
Definition
| 1) Clinical CHD 2) Sx CAD 3) PAD 4) AAA |
|
|
Term
| 5 major risk factors other than LDL that modify LDL goals? |
|
Definition
| 1) Smoking 2) HTN 3) HDL <40 4) Famhx of premature CHD 5) Men >45 and women >55 yo |
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|
Term
| What is considered a negative risk factor whose prescence removes one risk factor from the total count? |
|
Definition
|
|
Term
| What is the LDL goal for CHD or CHD risk equivalents (10 yr risk >20%)? What LDL level would you start TLC? Drug tx? |
|
Definition
|
|
Term
| What is the LDL goal for 2+ risk factors (10yr risk <20%)? What LDL level would you start TLC? Drug tx? |
|
Definition
| <130, >130, >130 if risk 10-20% or >160 if risk <10% |
|
|
Term
| What is the LDL goal for 0-1 risk factor? What LDL level would you start TLC? Drug tx? |
|
Definition
|
|
Term
| What is the TLC diet comprised of? |
|
Definition
| Sat fat <7% of kcals, chol <200/day, increase soluble fiber to 10-25gm/day and plant stanols/sterols to 2gm/day |
|
|
Term
| What are the 2 other non-dietary components of TLC? |
|
Definition
| weight management and increased physical activity |
|
|
Term
| What class of drugs are Cholestyramine, Colestipol, and Colesevalim? |
|
Definition
|
|
Term
| What is the common name for HMG Co-A reductase inhibitors? |
|
Definition
|
|
Term
| What are absolute contraindications for using statins? |
|
Definition
| active or chronic liver disease |
|
|
Term
| What are absolute contraindications for using bile acid sequestrants? |
|
Definition
| dysbetalipoproteinemia (TG >400) |
|
|
Term
| Besides skin flushing, what are some major side effects of nicotinic acid? |
|
Definition
| hyperglycemia, hyperuricemia (gout), Upper GI distress, hepatotoxicity |
|
|
Term
| What are absolute contraindications for using nicotinic acid? |
|
Definition
| chronic liver dz and severe gout |
|
|
Term
| What are relative contraindications for using nicotinic acids? |
|
Definition
|
|
Term
| What class of drugs are Gemfribrozil, Fenofibrate, and Clofibrate? |
|
Definition
|
|
Term
| What are absolute contraindications for using fibric acids? |
|
Definition
| severe renal or hepatic dz |
|
|
Term
| What are 5 categories that make up metabolic syndrome? |
|
Definition
| 1) Abd obesity - men >40in waist and women >35in 2) TG >150 3) HDL - men <40 and women <50 4) BP >130/>85 5) FSBS >110 |
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|
Term
| 5 tx for metabolic syndrome? |
|
Definition
| 1) Wt loss 2) Exercise 3) Tx HTN 4) Asprin for CHD pts 5) Tx TG and/or low HDL |
|
|
Term
| What are the ATP III levels for TG? |
|
Definition
| Normal - <150, Borderline high 150-199, high 200-499, very high >500 |
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