Bile Acid Sequents and Anorexia

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Questions and Answers

What is the physician's primary management for mild symptoms?

Immediately switching to a high-intensity dose of atorvastatin
Adding a non-statin lipid-lowering medication
Holding the statin and challenging once symptoms resolve (correct)
Reducing the dose of simvastatin to 10mg/day

What is the equivalent dose of atorvastatin to 20mg of simvastatin?

20mg (correct)
80mg
10mg
40mg

What is the LDL level of the patient in the scenario?

150mg/dL
195mg/dL (correct)
200mg/dL
220mg/dL

What is the term for abnormal lipoprotein levels?

Dyslipidemias (A) Signup and view all the answers

What is the physician's next step after the LDL level is found to be 195mg/dL?

Switching to a high-intensity dose of atorvastatin (D) Signup and view all the answers

What is the main goal of managing myalgia?

Resolving symptoms and reducing the risk of cardiovascular events (B) Signup and view all the answers

What percentage of bile acid sequants are associated with ovarian syndrome?

5% (C) Signup and view all the answers

Why is the physician avoiding drug interactions?

To ensure effective management of hyperlipidemia (C) Signup and view all the answers

Which of the following conditions is not associated with dyslipidemias?

Asthma (A) Signup and view all the answers

What is the reason for not using simvastatin 80mg/day?

It is not recommended due to its high intensity (C) Signup and view all the answers

What is the primary cause of primary dyslipidemias?

Genetic factors (A) Signup and view all the answers

What is the primary reason for drawing an cholesterol panel?

To monitor the patient's response to therapy (D) Signup and view all the answers

Which of the following is a secondary cause of dyslipidemias?

Smoking (D) Signup and view all the answers

What is the term for a group of symptoms associated with kidney disease?

Nephrotic syndrome (D) Signup and view all the answers

Which of the following is not a condition associated with dyslipidemias?

Asthma (C) Signup and view all the answers

What is the term for abnormal lipoprotein levels caused by lifestyle or medical conditions?

Secondary dyslipidemias (D) Signup and view all the answers

What is the primary consideration for a patient with a very high-risk and LDL remaining at 70mg/dL?

Maximize statin dose and consider adding ezetimibe (D) Signup and view all the answers

What is the mechanism of action of ezetimibe in reducing cholesterol levels?

It inhibits the absorption of cholesterol in the small intestine (B) Signup and view all the answers

What is the criteria for a patient to be considered high-risk?

History of multiple ASCVD events or one ASCVD event in a patient with diabetes (B) Signup and view all the answers

What is the target LDL level for a patient with primary hypercholesterolemia and statin at max dose?

LDL < 100mg/dL (B) Signup and view all the answers

What is the alternative treatment option for a patient with LDL remaining at 100mg/dL despite statin at max dose?

Add ezetimibe or PCSK9 inhibitors (B) Signup and view all the answers

What is the characteristic of a patient who would benefit from PCSK9 inhibitors?

History of multiple ASCVD events or one ASCVD event in a high-risk patient (C) Signup and view all the answers

What is the primary limitation of using barley and oat bran extracts in cholesterol synthesis?

They are limiting steps in cholesterol synthesis (A) Signup and view all the answers

What is the recommended statin treatment intensity for patients with clinical ASCVD?

High-intensity (D) Signup and view all the answers

What is the primary goal of statin treatment in patients with dyslipidemia?

To reduce ASCVD risk (C) Signup and view all the answers

What is the recommended statin treatment intensity for patients with LDL > 190 mg/dL?

High-intensity (D) Signup and view all the answers

What is the definition of high-intensity statin treatment?

A daily dose of 40-80 mg of statin (C) Signup and view all the answers

What is the recommended statin treatment intensity for patients with diabetes and LDL between 70-189 mg/dL?

Moderate-intensity (C) Signup and view all the answers

What is the primary factor in determining statin treatment intensity?

ASCVD risk (A) Signup and view all the answers

What is the recommended statin treatment intensity for patients with a 10-year ASCVD risk > 20%?

High-intensity (C) Signup and view all the answers

What is the definition of moderate-intensity statin treatment?

A daily dose of 20-40 mg of statin (B) Signup and view all the answers

What is the recommended statin treatment intensity for patients with a 10-year ASCVD risk between 7.5-19.9%?

Moderate-intensity (C) Signup and view all the answers

What is the primary contraindication for fenofibrate in patients with liver disease?

Severe liver disease, including primary biliary cirrhosis (A) Signup and view all the answers

What is the recommended dosage of fenofibric acid for treating hypertriglyceridemia?

43-130 mg daily (D) Signup and view all the answers

What is a common side effect of gemfibrozil?

Dyspepsia (A) Signup and view all the answers

What is the recommended dosage of Triglide for treating hypertriglyceridemia?

160 mg daily (A) Signup and view all the answers

What is the recommended dosage of Lipofen for treating hypertriglyceridemia?

50-150 mg daily (D) Signup and view all the answers

What is a contraindication for fenofibrate in patients with kidney disease?

Severe renal disease (CrCI < 30 mL/min) (B) Signup and view all the answers

What is the recommended dosage of fenofibrate for treating hypertriglyceridemia?

43-130 mg daily (B) Signup and view all the answers

What is a common side effect of fenofibrate?

Reversible tSCr (> 2 mg/dL) (A) Signup and view all the answers

What is the recommended dosage of gemfibrozil for treating hypertriglyceridemia?

600 mg BID, 30 minutes before breakfast and dinner (A) Signup and view all the answers

What is the effect of fibrate on lipid levels?

Decrease in TG, increase in HDL (B) Signup and view all the answers

Study Notes

Classification of Dyslipidemia

Dyslipidemia is a condition characterized by abnormal lipoprotein levels
Can be classified as primary (genetic cause) or secondary (due to lifestyle and/or medical conditions)
Abnormal lipoprotein levels can lead to liver disease, nephrotic syndrome, and other conditions

Conditions Associated with Dyslipidemia

Anorexia
Obesity
Poor diet
Hypothyroidism
Alcoholism
Smoking
Diabetes
Renal disease

Statin Treatment Intensity

Determining statin treatment intensity is based on patient risk
High-intensity statin treatment is recommended for patients with a high risk of ASCVD (Atherosclerotic Cardiovascular Disease)
Moderate-intensity statin treatment is recommended for patients with a moderate risk of ASCVD
Low-intensity statin treatment is recommended for patients with a low risk of ASCVD

Statin Benefit Groups

Secondary prevention: patients with clinical ASCVD
Primary prevention: patients with a high risk of ASCVD
Patients with diabetes and ages 40-75 years with LDL > 190 mg/dL
Patients with a 10-year ASCVD risk > 20%

Statin Treatment Options

Atorvastatin: high-intensity (40-80 mg) and moderate-intensity (10-20 mg) options
Rosuvastatin: high-intensity (20-40 mg) and moderate-intensity (5-10 mg) options
Simvastatin: high-intensity (40-80 mg) and moderate-intensity (20-40 mg) options
Pravastatin: moderate-intensity (40-80 mg) option
Lovastatin: moderate-intensity (40-80 mg) option
Fluvastatin: low-intensity (20-40 mg) option
Pitavastatin: low-intensity (2-4 mg) option

Non-Statins Treatment Options

Ezetimibe: preferred for patients with a high risk of ASCVD and LDL remains > 70 mg/dL
PCSK9 Inhibitors: recommended for patients with a high risk of ASCVD and LDL remains > 70 mg/dL
Fenofibrate: recommended for patients with primary hypercholesterolemia (LDL > 190 mg/dL) and LDL remains > 100 mg/dL

Fibrate Drug Interactions

Fenofibrate: can be used with caution in patients with renal disease and gallbladder disease
Gemfibrozil: can increase the risk of myopathy when used with statins, especially in the elderly, diabetes, and renal failure

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Description

This quiz covers the basics of bile acid sequents, its relation to anorexia, and other conditions associated with it. Test your knowledge of the medical concepts and their connections.