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?

    <p>Dyslipidemias</p> Signup and view all the answers

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

    <p>Switching to a high-intensity dose of atorvastatin</p> Signup and view all the answers

    What is the main goal of managing myalgia?

    <p>Resolving symptoms and reducing the risk of cardiovascular events</p> Signup and view all the answers

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

    <p>5%</p> Signup and view all the answers

    Why is the physician avoiding drug interactions?

    <p>To ensure effective management of hyperlipidemia</p> Signup and view all the answers

    Which of the following conditions is not associated with dyslipidemias?

    <p>Asthma</p> Signup and view all the answers

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

    <p>It is not recommended due to its high intensity</p> Signup and view all the answers

    What is the primary cause of primary dyslipidemias?

    <p>Genetic factors</p> Signup and view all the answers

    What is the primary reason for drawing an cholesterol panel?

    <p>To monitor the patient's response to therapy</p> Signup and view all the answers

    Which of the following is a secondary cause of dyslipidemias?

    <p>Smoking</p> Signup and view all the answers

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

    <p>Nephrotic syndrome</p> Signup and view all the answers

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

    <p>Asthma</p> Signup and view all the answers

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

    <p>Secondary dyslipidemias</p> 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?

    <p>Maximize statin dose and consider adding ezetimibe</p> Signup and view all the answers

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

    <p>It inhibits the absorption of cholesterol in the small intestine</p> Signup and view all the answers

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

    <p>History of multiple ASCVD events or one ASCVD event in a patient with diabetes</p> Signup and view all the answers

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

    <p>LDL &lt; 100mg/dL</p> 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?

    <p>Add ezetimibe or PCSK9 inhibitors</p> Signup and view all the answers

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

    <p>History of multiple ASCVD events or one ASCVD event in a high-risk patient</p> Signup and view all the answers

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

    <p>They are limiting steps in cholesterol synthesis</p> Signup and view all the answers

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

    <p>High-intensity</p> Signup and view all the answers

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

    <p>To reduce ASCVD risk</p> Signup and view all the answers

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

    <p>High-intensity</p> Signup and view all the answers

    What is the definition of high-intensity statin treatment?

    <p>A daily dose of 40-80 mg of statin</p> Signup and view all the answers

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

    <p>Moderate-intensity</p> Signup and view all the answers

    What is the primary factor in determining statin treatment intensity?

    <p>ASCVD risk</p> Signup and view all the answers

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

    <p>High-intensity</p> Signup and view all the answers

    What is the definition of moderate-intensity statin treatment?

    <p>A daily dose of 20-40 mg of statin</p> 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%?

    <p>Moderate-intensity</p> Signup and view all the answers

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

    <p>Severe liver disease, including primary biliary cirrhosis</p> Signup and view all the answers

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

    <p>43-130 mg daily</p> Signup and view all the answers

    What is a common side effect of gemfibrozil?

    <p>Dyspepsia</p> Signup and view all the answers

    What is the recommended dosage of Triglide for treating hypertriglyceridemia?

    <p>160 mg daily</p> Signup and view all the answers

    What is the recommended dosage of Lipofen for treating hypertriglyceridemia?

    <p>50-150 mg daily</p> Signup and view all the answers

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

    <p>Severe renal disease (CrCI &lt; 30 mL/min)</p> Signup and view all the answers

    What is the recommended dosage of fenofibrate for treating hypertriglyceridemia?

    <p>43-130 mg daily</p> Signup and view all the answers

    What is a common side effect of fenofibrate?

    <p>Reversible tSCr (&gt; 2 mg/dL)</p> Signup and view all the answers

    What is the recommended dosage of gemfibrozil for treating hypertriglyceridemia?

    <p>600 mg BID, 30 minutes before breakfast and dinner</p> Signup and view all the answers

    What is the effect of fibrate on lipid levels?

    <p>Decrease in TG, increase in HDL</p> 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.

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