Term
| 9 Steps in ATP III guidlines: pneumonic |
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Definition
LIPIDEMIA
L - lipoprotein levels
I - indurated arteries (atherosclerotic
P - possibility (risk factors)
I - IOyrs risk (framingham)
D - division of risk into category
E - exerscise (lifestyle changes)
M - medications
I - Insulin resistance/Increased BP (metabolic syndrome)
A - Action against Triglycerides |
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Term
Step I: Identify lipoprotein levels;
give goal levels for LDL, HDL, Total cholesterol. |
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Definition
LDL <100
HDL >40
Total Cholesterol <200 |
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Term
| what is defined as high: LDL,HDL,Cholesterol? |
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Definition
LDL 160-189 (high)
HDL >60 (high)
cholesterol >239 (high) |
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Term
| what are borderline high levels for LDL and cholesterol? |
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Definition
LDL 130-159 (borderline high)
cholesterol 200-239 (borderline high) |
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Term
| Step II: identify presence of atherosclerotic dz. what are 4 major atherscerlotic risks? |
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Definition
1. CHD
2. symptomatic carotid artery dz
3. PAD
4. AAA |
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Term
| Step III: determine major risk factors other than LDL. name 5: |
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Definition
1. smoking
2. HTN
3. low HDL
4. FHx of CHD
5. men >44yo & women >54yo |
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Term
| Step IV: If 2+ risk factors (other than LDL) are present without CHD or CHD risk equivalent, asses 10 year CHD risk: what is taken into account in determining the 10yr risk? |
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Definition
Framingham looks at:
1. Age
2. LDL
3. HDL
4. Chol
5. DM
6. BP
7. Smoker
each of these are worth points and total points correlate to %risk of developing CHD wn 10 years |
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Term
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Definition
| determine risk category & set LDL/Lifestyle changes/Drug goals according to category |
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Term
| what are the LDL goals for someone with CHD or equivalent? |
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Definition
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Term
| what is the 10yr risk for someone with CHD or equivalent? |
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Definition
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Term
| what is the LDL goal for someone with 2+ risk factors? |
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Definition
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Term
| what is the LDL goal for someone with 0-1 risk factor? |
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Definition
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Term
| what is the 10 year risk for someone with 2+ risk factors? |
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Definition
| less than or equal to 20% |
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Term
| at what LDL level do you consider drug therapy for patients with CHD or equivalent? |
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Definition
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Term
| at what LDL level do you consider drug therapy for patients with 2+ risk factors? |
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Definition
>130 LDL (risk 10-20%)
>160 LDL (risk <10%) |
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Term
| at what LDL level do you consider drug therapy for a patient who has 0-1 risk factor? |
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Definition
| >190 LDL & (LDL from 160-189 optional) |
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Term
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Definition
| initiate therapeutic lifestyle changes if LDL is above the goal. |
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Term
| what is the recommended saturated fat intake? |
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Definition
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Term
| what is the recommended cholesterol intake? |
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Definition
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Term
| what is the recommended fiber intake? |
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Definition
| 10-25g/day (enhance LDL lowering) |
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Term
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Definition
| drug therapy if LDL exceeds levels from step 5 |
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Term
| for patients with CHd or equivalent, what is the Tx plan if LDL is High? |
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Definition
| TLC &drug therapy simultaneously |
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Term
| in patients with risks <20%, at what point do you consider drug therapy after TLC initiated? |
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Definition
| after 3months TLC consider drug therapy |
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Term
| what are the 4 classes of lipoprotein affecting drugs? |
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Definition
1. statins
2. bile acid sequestrants
3. nicotinic acid
4. fibric acids |
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Term
| what are side affects of statins? |
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Definition
| Myopathy and increased liver enzymes |
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Term
| what are the side affects of bile seqs? |
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Definition
| GI distress, constipation, decrease absorption of other drugs/fat sol vitamins |
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Term
| what are the side affects of nicotinic acid? |
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Definition
| flushing, hyperglycemia, hyperuricemia, upper GI distress, hepatotoxicity |
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Term
| what are the side affects of fibric acids? |
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Definition
| dyspepsia, gallstones, myopathy |
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Term
| what are conraindications for statins? |
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Definition
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Term
| contraindication for bile acid seq: |
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Definition
| TG>400 & dysbetalipoproteinemia |
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Term
| contraindications for nicotinic acid: |
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Definition
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Term
| contraindication for fibric acid: |
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Definition
| renal dz & severe hepatic dz |
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Term
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Definition
| identify metabolic dz and tx if present after 3 months TLC |
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Term
| metabolic syndrome is identified as: |
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Definition
any 3 of the following:
1. abdominal obesity
2. Trig >150
3. HDL <50
4. BP >130/>85
5. fasting glu >110 |
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Term
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Definition
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Term
| normal triglyceride level: |
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Definition
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Term
| borderline high trig level: |
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Definition
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Term
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Definition
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Term
| the primary goal of ATP III: |
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Definition
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