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HYPERLIPIDEMIA

CHIEF COMPLAINT

Hyperlipidemia

HPI

Symptom list

• Ischemic vascular disease


• Pancreatitis
• Xanthomatosis
• Atherosclerosis
• Peripheral vascular disease
• cerebrovascular disease
• Hypertriglyceridemia
• Obesity
• Glucose intolerance
• Chest pain (angina)

Severity
• Mild
• Moderate
• Severe
• Absent
• Normal
• Increased
• Decreased
• Stable
• no significant change from prior visit

HISTORY (PMFSH)

PAST HISTORY

• Diabetes mellitus
• Hypothyroidism
• Obstructive liver disease
• Chronic renal failure
• Metabolic Syndrome
• Drugs
o Progestins
o Anabolic steroids
o corticosteroids
o anorexia nervosa
o Glucocorticoids
o Estrogens
o Oral contraceptives
o Antihypertensives
• Alcoholism

ALLERGY
Drugs
Environment

FAMILY HISTORY

• High cholesterol levels


• Early coronary artery disease
• Heart diseases
• Hypertension
• Hypothyroidism
• Obesity
• Diabetes mellitus

SOCIAL HISTORY

Habits
• Alcoholism
• Drugs___
• Smoking
Occupation

ROS

PHYSICAL EXAMINATION

SPECIFIC DATA LIKE GRADING ETC

FREDRICKSON CLASSIFICATION

TYPE I
Buerger-Gruetz syndrome
Primary hyperlipoproteinaemia
Familial hyperchylomicronemia

TYPE II
TYPE IIA
Polygenic hypercholesterolaemia
Familial hypercholesterolemia

Type IIb
Combined hyperlipidemia

Type III
Familial Dysbetalipoproteinemia

Type IV
Endogenous Hyperlipemia

Type V
Familial Hypertriglyceridemia

TESTS TO BE ORDERED

Blood tests
• CBP
• FBS
• PLBS
• RBS
• Serum amylase
• Cholesterol Screening
o fasting total cholesterol
o LDL cholesterol
o high-density lipoprotein (HDL) cholesterol
o triglyceride levels
• Apolipoprotein B100 test
• Genetic testing
• Liver function tests
• Renal function tests
• Thyroid function tests

Urinalysis
o Macroscopic
 Urine Bilirubin
 Urine Blood
 Urine Casts
 Urine Color
 Urine Glucose
 Urine Ketones
 Urine pH
 Urine Protein
 Specific Gravity
 Urine Urobilinogen
o Microscopic
 Urine WBS/hpf
 Urine RBC/hpf
 Urine Casts
 Urine Other
• Chest X-ray
• ECG
• 2D Echo
• Angiography
• CT-scan
• MRI

ASSESSMENT/PLAN & INSTRUCTIONS/EDUCATION

• Limit taking of saturated fats


• Increase intake of soluble fiber found in oats, peas, beans,
and certain fruits
• Increase intake of plant stanols or sterols, found in nuts,
vegetable oils, corn, and rice.
• Take Cold-water fish, such as mackerel, sardines, and salmon
and Soy, such as tofu and soy nuts.
• Add or increase psyllium in diet
• Quite smoking
• Intensify weight management
• Increase physical activity
• Control hypertension
• Patients should restrict their dietary cholesterol intake to less
than 200 mg/day.
• Eat foods that contain plant stanols and sterols (eg, certain
margarines and salad dressings) and soluble fiber (eg, cereal
grains, beans, peas, legumes, fruits, and vegetables).

MEDICATION

• Atorvastatin
• Cerivastatin
• Lovastatin
• Fluvastatin
• Pravastatin
• Simvastatin
• Niacin
• Gemfibrozil
• Clofibrate
• Fenofibrate
• Cholestyramine
• Colestipol
• Bezafibrate
• Ciprofibrate
• Omega-3-acid ethyl esters

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