CVS Module_Dr P KUMAR (Carnitine) MSU BIO-GEN INNOVISION 2014 2014

Plasma Homocysteine (Hcy) & Coronary Heart Disease (CHD)

All of the following statements regarding homocysteine (Hcy) are true EXCEPT: A. Inherited defects of methionine metabolism may cause extremely high serum levels of homocysteine and premature atherothrombosis. B. Polymorphisms in the methylene tetrahydrofolate reductase gene are associated with elevated homocysteine levels. C. Epidemiologic studies have linked mild hyperhomocystinemia with an increased risk of coronary events. D. Folic acid and other vitamin B supplements reduce serum homocysteine levels. E. Dietary supplementation with a combination of B vitamins (folic acid, B6 and B12) reduces the risk of atherothrombotic events.

(C) DR P KUMAR JAN 2014 Author Gratefully Acknowledges All

On-Line Resources, TQ.

“ MOTHER is a Single Word, But it is a Combination of Love, Care, Mercy, Dedication, Precious & Boon”

DYSLIPIDEMIA: Male patient aged 35 ys. C/o of skin lesions over the extensor

surface of both elbows and knees. Bp 130/80, pulse 80 regular.

• Neck

• Chest

• Heart

• Abd

• N S

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

Ask patient 3 questions:

• Family history DM,

• Dyslipedimia

• Early IHD in family

• Thyroid disease

• Drug intake

• Liver,kidney diseases.

Inferiolateral ischemia

Investigations recommended

• Lipid profile

• Liver function

• Renal function

• Thyroid function

• Cardiology consultation Why?

Causes of secondary hyperlipidemia

• Cholestatic liver diseases

• Nephrotic syndrome

• Chronic renal failure

• Hypothyroidism

• Cigarette smoking

• Obesity

• Drugs.

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

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

ADR of Statins: Statins , Rhabdomyalgia , Rhabdomyolysis / Renal impairement, Raise transaminases , GIT.

DR P KUMAR JAN 2014

Write a Short Note & Its Clinical Significance of the Items 1-14 DR P

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BIO-GEN I

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