Dyslipidaemia

             

      1 Familial (primary) dyslipidaemia

● Due to gene mutation(s).
● Should be suspected in patients with premature IHD (age <55 in men, <60 in women).
● WHO classifies them type 1-5 (T1-5).

       2 Acquired (secondary) dyslipidaemia

Most cases of dyslipidaemia are acquired in later life. Obesity, sedentary lifestyle, and diabetes are common risk factors, though many cases are essentially idiopathic.

Other causes:

● Endocrine: hypothyroidism, hypopituitarism.
● Hepatic: alcohol excess, cholestasis.
● Renal: nephrotic syndrome, chronic kidney disease.
● Others: pregnancy, anorexia, gout, antipsychotics.

     Signs and symptoms

Usually detected through CVD risk assessment, or when presenting with complications such as IHD or stroke.

The only specific sign is lipid deposits (xanthomas). Their presence and extent are a sign of disease severity. Locations:

● Eyelids: xanthelasma (also seen in smoking).
● Eyes: corneal arcus and retinal deposits.
● Tendon xanthoma: achilles (run finger and thumb along to feel for lumps) and digital extensor tendons. Especially seen in T2 hyperlipidaemia.
● Knees and elbows: xanthoma tuberosum and tuboeruptive xanthoma (with red papules). Seen in T3 hyperlipidaemia.
● Palms and flexures: palmar xanthoma.

Comments

Post a Comment

Popular posts from this blog

Colon polyps

Image
A colon polyp is a small clump of cells that forms on the lining of the colon. Most colon polyps are harmless. But over time, some colon polyps can develop into colon cancer, which is often fatal when found in its later stages. There are two main categories of polyps, non-neoplastic and neoplastic. Non-neoplastic polyps include hyperplastic polyps, inflammatory polyps and hamartomatous polyps. These types of polyps typically do not become cancerous. Neoplastic polyps include adenomas and serrated types. In general, the larger a polyp, the greater the risk of cancer, especially with neoplastic polyps. Anyone can develop colon polyps. You're at higher risk if you're 50 or older, are overweight or a smoker, or have a personal or family history of colon polyps or colon cancer. Colon polyps often don't cause symptoms. It's important to have regular screening tests, such as a colonoscopy, because colon polyps found in the early stages can usually be removed safely a...
Read more

Polyhydramnios

Image
Polyhydramnios  is the excessive accumulation of amniotic fluid — the fluid that surrounds the baby in the uterus during pregnancy. Polyhydramnios occurs in about 1 to 2 percent of pregnancies. Most cases of polyhydramnios are mild and result from a gradual buildup of amniotic fluid during the second half of pregnancy. Severe polyhydramnios may cause shortness of breath, preterm labor, Symptoms Polyhydramnios symptoms result from pressure being exerted within the uterus and on nearby organs. Mild polyhydramnios may cause few — if any — signs or symptoms. Severe polyhydramnios may cause: Shortness of breath or the inability to breathe Swelling in the lower extremities and abdominal wall Uterine discomfort or contractions Fetal malposition, such as breech presentation Your health care provider may also suspect polyhydramnios if your uterus is excessively enlarged and he or she has trouble feeling the baby. Causes Some of the known causes of polyhydramnios ...
Read more
Image
Nephrolithiasis • Calcium oxalate (and to some degree calcium phosphate) stones account for 80% of all kidney stones • Remaining stones are uric acid (10%), struvite (10-15%) and cystine (1%) stones • It is possible for patient to have multiple stones and for them to be more than one type of stone Risk Factors • Crystallization occurs when otherwise soluble solutes precipitate due to supersaturation or changes in urinary pH, protein content, or due to reaction with other solutes • Crystals cause epithelial injury, deposition of stone formation, bleeding, obstruction, and pain • Frequently identified risk factors include hypercalciuria, hyperoxaluria, hypocitraturia, decreased calcium intake, increased oxalate intake, increased animal protein intake, and decreased hydration • There is more than 2-fold increase in risk of kidney stones with positive family hx of kidney stones • Patients with history of kidney stones have a 10-30% 3-5 year recurrence rate • 25% of people with gout will ge...
Read more