Dyslipidemia case study

1. Male patient aged 35 ys
C/o of skin lesions over the
extensor surface of both elbows
and knees

2. Bp 130/80, pulse 80 regular
 Neck
 Chest
 Heart
 Abd
NS

3. Lab Values
 Total cholesterol
508 mg%
 Trigliceride 2894
 Random Sugar 338
 ECG T wave changes in LIII, aVF,V3-V6

4. Ask patient 3 questions
 Family history DM,
 Dyslipedimia
 Early IHD in family
 Thyroid disease
 Drug intake
 Liver,kidney diseases

5. Inferiolateral ischemia

6. Investigations recomended
 Lipid profile
 Liver function
 Renal function
 Thyroid function
 Cardiology consultation Why?

7. Causes of secondary
hyperlipidemia
 Cholestatic liver diseases
 Nephrotic syndrome
 Chronic renal failure
 Hypothyroidism
 Cigarette smoking
 Obesity
 Drugs

8. Expected complications
 IHD, accelerated atherosclerosis
 Pancreatitis
 Gall bladder disease
 Related to medications
 Complications of Diabetes

9. Lipoprotein

10. Type of lipoproteins

11. Lipoproteins suclasses

12. Dyslipedimia

13. Lipid Fredrekhsen classification

14. Plan of your treatment
 Diet
 Diabetes control
 IHD, accelerated atherosclerosis
 Hypolipemic
medications,Statin,Fibrate,Resin
uptake,ezetimibe, nicotinic acid,lipid
apheresis
 others

15. Mechanism of action Statins
 Are specific competitive inhibitors of
microsomal enzyme HMG-CoA reductase,
which catalyses the conversion HMG-Co
A
To mevalonate, a rate- determining step in
cholesterol synthesis

16. Mechanism of action of Fibrates

17. ADR of Statins
 Statins , Rhabdomyalgia ,
Rhabdomyolysis
 Renal impairement
 Raise transaminases
 GIT

18. APHERESIS