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Henry 17

Lipids and Dyslipoproteinemia

Cholesterol travels in circulation in spherical particles containing both lipids and proteins. These particles are called? lipoproteins
what are the three main classes of lipoproteins measured in the serum VLDL, LDL, HDL
VLDL are composed mostly of? triglycerides
what is the main atherogenic class of lipoproteins LDL
How does HDL affect ones risk for development of atherosclerosis inversely
what is the optimal level for LDL <100 (100-129 is near optimal/above optimal) and (130-159 is borderline high)
what level of LDL is high >160 ( > 190 is very high)
what level of Total cholesterol is desirable <200 (200-239 is borderline high)
what level of total cholesterol is high >240
what level of HDL is desireable >40 (<40 is low and >60 is high)
what are the 5 modifiable CHD risk factors 1) Smoking 2)Hypertension 3) Low HDL 4) Family Hx 5) Age
oxidation of LDL has been shown to increase atherogenesis how can that be inhibited anti-oxidants
what is the only gentically determined component of lipoproteins apolipoproteins
what is the major protein component of HDL particles Apolipoprotein A1
what is the major protein component of LDl Apolipoprotein B100
how does Lp(a) affect thrombosis Lp(a) can compete for the binding of plasminogen to its cell membrane receptor on the endothelial surface
how does homocysteine enhance the atherosclerotic process Generation of superoxide and hydrogen peroxide, enhanced coagulation, inhibiting dilation of small arteries, promoting smooth muscle proliferation
what happens when Homocystein and LDL interact they form LDL-homocysteine thiolactone aggregates which are taken up by macrophages and subsequently incorporated into foam cells in early atherosclerotic plaques
how can you lower serum concentrations of homocysteine treatment with daily supplements of folic acid, vitamins B6 and B12
what is a better predictor of cardiovascular events fasting or non-fasting triglycerides non-fasting triglycerides
how are foam cells formed from LDL Ox-LDL is taken up in macrophage scavenger receptors, promoting cholesterol ester accumulation and foam cell formation
How is percentage error related to bias and CV as per NCEP guidelines % total error = %bias + 1.96 * (%CV)
What is the % total error acceptability limit for Total Cholesterol <=9%
What is the % total error acceptability limit for Triglycerides <=15%
What is the % total error acceptability limit for HDL Cholesterol <=13%
What is the % total error acceptability limit for LDL Cholesterol <=12%
What is the % total error for Cholesterol in a laboratory with a bias of 3.5% and a CV of 2%
For evaluation of elevated cholesterol levels, diabetic patients are treated like patients who already have CHD. Diabetes confers a high risk of new CHD within how many years? 10 years
ATP III (3rd report of NCEP 2002) , recognized for evaluation of elevated cholesterol levels which two conditions as candidates for intensive intervention and therapy Metabolic Syndrome and patients with a high 10 year risk for CHD based on the Framingham risk projections
Is the focus of NCSP guidelines on recognizing abnormal and normal cholesterol values No, it is shifted to assessing overall cardiovascular risk based on cutoffs for cholesterol, triglycerides, HDL-C and LDL-C
What are the tests recommended by ATP III as initial test for evaluating blood cholesterol Complete lipoprotein profile - TC, LDL-C, HDL-C and Triglycerides
how often should a fasting lipoprotein profile be obtained in adults over 20 it should be obtained every 5 years
In a patient that is non-fasting what parts of the fasting lipoprotein profile will be usable the Total Cholesterol and HDL will be usable (get follow-up if TC is >200 or HDL is <40)
What is the primary target for Cholesterol lowering therapy LDL-C
what is the LDL goal if you have CHD or CHD risk equivalents <100
what is the LDL goal if you have 2+ risk factors <130
what is the LDL goal if you have 0-1 risk factors <160
What are the two approaches used to reach LDL-C goal Therapeutic lifestyle change (TLC) and drug therapy
What are components of Therapeutic Lifestyle change Dietary change and increased physical activity, combined with regular follow-up - this represents 1st line of therapy (may be combined initially with drug therapy in high risk patients)
What are the drugs used for hyperlipidemia Statins, fibric acid derivatives, bile acid resins, and nicotinic acid
Created by: docamrish



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