Hyperlipidemia 1

Question 1

__________= Elevation of both total cholesterol and triglycerides

Answer 1

Hyperlipidemia (HLD)

Question 2

Which type of dyslipidemia?

•Genetic abnormality of cholesterol metabolism

Answer 2

Primary dyslipidemia

Question 3

Which type of dyslipidemia?

• Diabetes mellitus
• Excessive alcohol use
• Hypothyroidism
• Cholestatic liver disease
• Renal disease
• Smoking
• Obesity

Answer 3

Secondary Dyslipidemia

Question 4

The following medications are for which type of dyslipidemia?

1. OCPs
2. thiazide diuretics
3. beta blockers
4. some atypical antipsychotics
5. protease inhibitors

Answer 4

Secondary dyslipidemia

Question 5

What are the 2 main types of lipids?

Answer 5

1. Cholesterol (helps form steroid hormones and bile acids)
2. Triglycerides (helps transfer energy from food to cells)

Question 6

________= how lipids are transported

• Contain proteins – “apoproteins”
• Classified by density
  
  • Low density = more triglycerides
  • High density = more apoproteins

Answer 6

Lipoproteins

Question 7

Transport:

1. Liver uses fat and CHO stores to make VLDL
2. VLDL transfers TG to cells
3. As VLDL loses TG, LDL created
4. LDL provides cholesterol to cells
5. Excess LDL taken up by liver, cholesterol excreted into bile
6. HDL made in liver & intestine

Answer 7

Question 8

What is HDL’s role in the transport of lipids?

Answer 8

• HDL is made in liver and intestine
• Helps with apoprotein transport & reversal of cholesterol transport (transfers cholesterol to other lipoproteins or directly into liver)

Question 9

How is cholesterol carried?

Total cholesterol= ____ + ______ + ______

Answer 9

Total Cholesterol = HDL + VLDL + LDL

Question 10

Lipid fractions:

Most clinical laboratories MEASURE ________, _________, and _______

Answer 10

total cholesterol, triglycerides, and HDL

Question 11

Most triglycerides are found in ______particles

Answer 11

VLDL

VLDL cholesterol= TG/5

**Must be fasting to give lowest TG (if TG too high, estimation of LDL can be wrong)**

Question 12

Primary or Secondary prevention of CVD?

No evidence of atherosclerotic cardiovascular disease (ASCVD)

Answer 12

Primary Prevention of CVD

-Want to prevent development of CVD

Question 13

Primary or Secondary prevention of CVD?

–Known ASCVD

–Goal = prevention of a second event

Answer 13

Secondary prevention

Question 14

The following constitutes_________:

–Coronary heart disease (CHD)

–Cerebrovascular disease

–Peripheral artery disease

–Aortic atherosclerosis and thoracic or abdominal aortic aneurysm

Answer 14

Cardiovascular Disease (CVD)

Question 15

______= Fatty material collects in arterial walls, hardening over time

Answer 15

ACSVD

Question 16

Process of _______ is started by excess cholesterol (VLDL and LDL)

• Result of abnormal cholesterol metabolism
  
  • Genetic
  • Insulin resistance
  • Organ dysfunction
• Process enhanced by lifestyle factors

Answer 16

ASCVD

Question 17

The process of ASCVD is enhanced by what lifestyle factors?

Answer 17

• Saturated fats/ trans-fats
• Obesity
• Smoking
• Blood pressure level

Question 18

The following are steps of _______ formation:

1. Small, dense LDL enters and “sticks” to artery wall
2. Triggers cascade of events
   
   • Oxidation of LDL (Pro-inflammatory, thrombotic)
   • Attracts macrophages–> foam cells
   • Endothelial dysfunction
   • Vasoconstriction

Answer 18

Plaque formation

Question 19

What does plaque rupture result in?

Answer 19

1. MI in coronaries
2. TIA or CVA in brain

Question 20

The following are non-modifiable or modifiable cardiovascular risk factors?

• Age (Men > 45 y/o, Women > 55 y/o)
• Sex
• Family history of premature heart disease in first degree relative
• Men < 55 y/o
• Women < 65 y/o

Answer 20

non-modifiable

Question 21

The following are non-modifiable or modifiable cardiovascular risk factors?

1. HTN
2. DM
3. Dyslipidemia
4. Kidney disease
5. Obesity
6. Smoking
7. HDL

Answer 21

Modifiable risk factors

Question 22

•50% of CVD diagnoses and 15% of CVD deaths are in patients < ___ y/o

Answer 22

<65y/o

Question 23

What is the main difference between ‘Hard’ Coronary Framingham risk score and ACC/AHA ASCVD Risk Estimator Plus?

Answer 23

‘Hard’ Coronary Framingham risk score identifies 10 year risk of MI or death whereas ACC/AHA showed 10 yr risk of heart disease or stroke

**Also, ACC/AHA includes race

Question 24

The following is included in which CVD risk calculators?

1. Age
2. Sex
3. Smoker
4. Total cholesterol
5. HDL cholesterol
6. SBP
7. Blood pressure treated with meds?

Answer 24

‘Hard’ Coronary Framingham risk score

Question 25

The following are included in which CVD risk calculator? 1. Age 2. Sex 3. **Race (AA or other)** 4. Total cholesterol 5. LDL cholesterol 6. HDL cholesterol 7. Statin treatment? 8. SBP 9. Hypertension treatment? 10. Diabetes 11. Current smoker 12. Aspirin therapy

Answer 25

ACC/AHA ASCVD risk estimator plus (10 yr risk of heart disease or stroke)

Question 26

HIGH LDL= _____ ASCVD risk

Answer 26

High

Question 27

High HDL= ____ ASCVD risk

Answer 27

LOW