Exam (elaborations)
PCF- Lipid Disorders (1)
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PCF- Lipid Disorders (1)
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PCF- Lipid DisordersPhysiology of lipid production - ANS-LDL: Lipoprotein that is primarily responsible for the
delivery of cholesterol to the tissues for cellular function, sometimes deliver it to walls of arteries.
HDL: Consists of apoproteins and cholesterol, synthesized in liver and intestine. They appear to
participate in reverse cholesterol transport, which is the process in which cholesterol within
peripheral tissue is transferred into HDL and excreted through the liver.
Role of lipoproteins - ANS--Transport lipids around the body because lipids are insoluble in
water.
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Incidence and Prevalence of Dyslipidemia - ANS--Western civilizations cholesterol values are
~20% higher than Asia
-Very High TC (>240) is 11.8%
-High LDL (>130) is 30.3%
-High TC (>200) 38.2%
-Low HDL (<40) is 19.2%
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Contribution of dyslipidemia to CHD - ANS-Too much cholesterol in the blood may lead to fatty
deposits within arterial walls.
Importance of LDL elevation - ANS-It is causal, although not 1:1. For example, with familial
hypercholesterolemia (LDL >190, plus family hx) there is a 6-20 times increase of CVD. CHD
events happen 10-20 sooner in males and 20-30 years sooner in females on average.
Importance of HDL depression - ANS-If HDL is low, then cholesterol is not being sufficiently
removed from the tissues causing unnecessary buildup.
Classifications of Dyslipidemias - ANS-Primary (1st degree): Single or multiple gene mutations.
Result in either overproduction or defective clearance of triglycerides and LDL or
underproduction or excessive clearance of HDL.
Secondary (2nd degree): Related to lifestyle or other diseases that have an impact on lipid
metabolism or mechanisms.
Who to screen and how often? - ANS-Men: All 35+ (grade A), 20-35 @ increased risk (grade B)
Women: 45+ @ increased risk (grade A), women 20-45 @ increased risk (grade B)
Screening usually every 5 years. Less if abnormal results.
Viet's bias also includes when pt has family hx of familial hypercholesterolemia, ACS, type 1
DM, a hx of coronary calcium incident, and kids under 20 should have at least one test done
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