Risk Factors and Screening
Risk Categories
Stepwise Treatment for TLC
Managing Myopathy
LDL Goals and Initiating Drug Therapy Cut offs
100
A Fasting lipid pofile is completed after this many hours of fasting and gives information on these 4 values
What is 9-12 hour fast and TC, TG, HDL, LDL
100
A patient with CHD or CHD equivalent is in this risk category (choose either high, mod high, mod or low risk)
What is High risk
100
TLC is initiated for this time period initially
What is 6 weeks
100
This is done if a patient has CK>10x ULN w/ muscle symptoms
What is D/C statins
100
The goal LDL and drug therapy cutoffs for High Risk Category
What is goal LDL-C <100 or optional <70 and drug therapy >100 or optional drug therapy if <100
200
Screening should begin in adults after this age and continued this frequently
What is >20 years old and every 5 years
200
A person with 0-1 risk factors is in this category (choose either high, mod high, mod or low risk)
What is low risk
200
After 6 weeks of TLC the patient has failed to achieve goal LDL this is the next step
What is reinforce TLC and recheck in 6 weeks
200
This is done if a patient has a CK 3-10x ULN w/ muscle symptoms
What is continue statin and follow symptoms and CK weekly
200
The goal LDL and drug therapy cutoffs for moderately high risk
What is LDL-C of <130 and drug therapy >130
300
CHD or CHD equivalents (name two)
What is Coronary Heart Disease (signs of stable angina, history of unstable angina, MI or revascularization procedures such as CABG, PCI or stents), non-coronary atherosclerosis (CVA, TIA, PAD, abdominal aortic aneurysm), Diabetes, 10 year risk > or = 20%)
300
A patient without CHD or a CHD equivalent and has 2 or more risk factors and a FRS <10% is in this risk category (choose either high, mod high, mod or low risk)
What is moderate risk
300
Two 6 week intervals of TLC have been attempted with BP goal not met, this is the next step
What is consider drug therapy
300
This is done if a patient has a CK>10x ULN w/o muscle symptoms
What is discontiue statin until CK returns to normal then restart at lower dose or choose different statin
300
The goal LDL and drug therapy cutoffs for moderate risk
What is LDL <130 and drug therapy >160
400
Three non-modifiable risk factors
What is cigarette smoking, HTN (>140/90), low HDL cholesterol
400
A patient without CHD or a CHD equivalent, has 2 or more risk factors and a FRS >20% is in this risk category (choose either high, mod high, mod or low risk)
What is high risk
400
Monitoring of TLC adherence and response is completed this often after several attempts at TLC and after drug therapy initiated
What is every 4-6 months
400
This is done if a patient has a CK 3-10xULN w/o muscle symptoms
What is continue statin and frequently monitor symptoms and CK
400
The goal LDL and drug therapy cutoffs for lower risk
What is LDL <160 and drug therapy >190 (may consider drug therapy b/t 160-189)
500
This equation can be used to determine LDL when direct levels can not be drawn and is only accurate under this condition
What is (Friedewald equation) LDL= TC-HDL-TG/5, accurate when TG<400mg/dL
500
A patient without CHD or a CHD equivalent and has 2 or more risk factors and a FRS b/t 10-20% is in this risk category (choose either high, mod high, mod or low risk)
What is moderately high
500
LDL values for initiating TLC for different risk categories (high, mod high, mod, low)
What is >or=100 for high, >or=130 for mod high or mod, and >or=160 for low
500
These are good statin options to change to if CK levels are elevated and have returned to normal after d/c previous statin
What is rosuvastatin and pravastatin
500
The optional goal for LDL of <70mg/dL should be considered in these patients
What is very high risk patients=DM, ACS, metabolic syndrome, or severe uncorrected factors
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