Term
| Is a male's waist of 38 inches clinically identified as metabolic syndrome? |
|
Definition
| No. A waist circumference of >40 inches is clinically identified as metabolic syndrome |
|
|
Term
| Is a female's waist of 38 inches clinically identified as metabolic syndrome? |
|
Definition
| Yes - a waist circumference of >35" in females is clinically identified as metabolic syndrome if accompanied with + 2 more risk factors. |
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Term
| Is a triglyceride level of 155 mg/dL clinically identified? |
|
Definition
| Yes, TG > 150 + 2 more risk factors |
|
|
Term
| Is an HDL of 39 clinically identified as metabolic syndrome? |
|
Definition
| Yes - Men < 50; women <40 + 2 more risk factors. |
|
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Term
| Is a fasting glucose of >/= to 110mg/dL clinically identified as metabolic syndrome? |
|
Definition
| Yes, if accompanied by +2 more risk factors. |
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Term
| Does a BP of >/= 130/85 mmHg indicate metabolic syndrome? |
|
Definition
| Yes, if accompanied with + 2 more risk factors. |
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Term
| What is the LDL goal for CHD or CHD risk equivalents (10-year risk >20%) |
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Definition
|
|
Term
| What is the LDL goal for 2+ risk factors (10-year risk |
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Definition
|
|
Term
| What is the LDL goal for 0-1 risk factor? |
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Definition
|
|
Term
| Is diabetes considered a CHF equivalent (ATP III)? |
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Definition
|
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Term
| What major risk factors (exclusive of LDL cholesterol) modify LDL goals (ATP III)? |
|
Definition
| Cigarette smoking; HTN or antihypertensive med; low HDL (<40 mg/dL); Family hx of premature CHD (1st degree males <55 y.o. females <65 y.o.); age (men >/= 45; women >/= 55). |
|
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Term
| Do clinical CHD, symptomatic carotid artery disease, peripheral arterial disease and AAA confer high risk/CHD risk equivalents? |
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Definition
|
|
Term
| What percentage according to the Framingham tables indicates CHD risk equivalent? |
|
Definition
|
|
Term
| What are some CHD risk equivalents (6)? |
|
Definition
| Peripheral artery disease, AAA, thrombotic stroke, transient ischemic attacks, diabetes, 10-year CHD risk >20% |
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Term
| What are historical examples of CHD for goal-setting purposes in serum lipid management? |
|
Definition
| MI, myocardial ischemia, stable angina, unstable angina, percutaneous transluminal coronary angioplasty (PTCA), CABG |
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|
Term
| What do 2/3 of DM patients die from? |
|
Definition
| Heart or blood vessel disease. |
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Term
| Should a CHD or CHD risk equivalent pt be initiated on lipolytic therapy with an LDL of 120? |
|
Definition
| Optional, this patient should first start therapeutic lifestyle changes, but drug therapy is optional in this category. |
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|
Term
| Should a pt with 2+ risk factors (for CHD risk equivalent) be initiated on lipolytic therapy with an LDL of 120? |
|
Definition
| No, but therapeutic lifestyle changes should begin if the pts LDL's rise above 130. |
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|
Term
| In pts with 0-1 risk factors (for CHD risk equivalency), what level should therapeutic lifestyle changes be initiated? |
|
Definition
|
|
Term
| In pts with 0-1 risk factors (for CHD risk equivalency), should lipolytic drug therapy be initiated at an LDL of 186mg/dL? |
|
Definition
| It's optional between 160-189mg/dL in the 0-1 risk factor category. |
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|
Term
| In pts with 2+ risk factors, but with 10-year risk <10%, at what LDL level should lipolytic drug therapy be initiated? |
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Definition
|
|
Term
| On the TLC diet, saturated fats should be less than what percentage of calories? |
|
Definition
|
|
Term
| Total cholesterol per day should be less than what, when applying the TLC diet? |
|
Definition
|
|
Term
| After initiating therapeutic lifestyle changes (in pts not CHD-equivalent), after how many months should lipolytic drug therapy be initiated? |
|
Definition
|
|
Term
| What drug class is most effective at lowering serum LDL's? |
|
Definition
| HMG CoA reductase inhibitors (statins). |
|
|
Term
| What drug class is the least effective at lowering serum LDL's (ATP III)? |
|
Definition
| Fibric acid derivatives. months. |
|
|
Term
| How well do bile acid sequestrants lower triglyceride levels? |
|
Definition
|
|
Term
| What 2 drug classes are equally effective at lowering triglyceride levels (ATP III)? |
|
Definition
| Nicotinic acid (Niaspan), and fibric acid derivatives. |
|
|
Term
| What antiinfective agents are contraindicated with statin use? |
|
Definition
| cyclosporine, macrolide antibiotics, various anti-fungal agents. |
|
|
Term
| What are 2 key side effects of HMG CoA reductase inhibitor (statins) use? |
|
Definition
| myopathy and increased liver enzymes. |
|
|
Term
| What lipolytic drug class is the only one to not list liver disease as a contraindication? |
|
Definition
|
|
Term
| What lipolytic drug causes flushing which can be reduced by premedicating with aspirin? |
|
Definition
|
|
Term
| What lipolytic is most effective at raising HDL's? |
|
Definition
|
|
Term
| What lipolytic drug class has a side effect profile that includes dyspepsia, gallstones, and myopathy? |
|
Definition
|
|
Term
| In pts with severe gout, what lipolytic drug should not be used? |
|
Definition
|
|
Term
| What lipolytic drug class can decrease the absorption of other drugs, cause constipation and GI distress? |
|
Definition
|
|
Term
| What waist circumferences are indicative of metabolic syndrome (when accompanied with 2 more risk factors) in men and women? |
|
Definition
|
|
Term
| What FSBS (accompanied with 2 more risk factors) is indicative of metabolic syndrome? |
|
Definition
|
|
Term
| If a pt's triglyceride level is 200-499mg/dL after LDL goal is reached, what next step should a practitioner take? |
|
Definition
| Intensify therapy w/ LDL-lowering drug, or add nicotinic acid or fibrate to further lower VLDL. |
|
|
Term
| At what serum triglyceride level should triglycerides be lowered first to prevent pancreatitis? |
|
Definition
|
|
Term
| Does nicotinamide have a lipid-lowering effect? |
|
Definition
|
|
Term
| What is the mechanism of action of niacin (nicotinic acid)? |
|
Definition
| It reduces hepatic synthesis of VLDL & LDL and reduces HDL catabolism. |
|
|
Term
| HMG CoA reductase inhibitors, combined with what antilipidemic drug class, increases the likelihood of developing rhabdomyelosis? |
|
Definition
|
|
Term
| What antilipidemic is more notorious for causing constipation and GI disturbances? |
|
Definition
|
|
Term
| What can concomitant alcohol ingestion with nicotinic acid cause? |
|
Definition
| Possible increased flushing. |
|
|
Term
| By how many hours should niacin and bile acid sequestrants be separated by? |
|
Definition
|
|
Term
| What can omega-3-fatty acids (Lovaza) increase and decrease? |
|
Definition
| Omega 3's can Lower TG by 45-50%, raise HDL by 9% and raise LDL by 45-50%. |
|
|
Term
| Can HMG-CoA reductase inhibitors (statins) be safely used with bile acid sequestrants? |
|
Definition
|
|
Term
| Should statin-drug combinations be used for first line defense? |
|
Definition
|
|
Term
| Which HMG CoA reductase inhibitor (statin) is most efficacious? |
|
Definition
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