Hypercholesterolemia - CRASH! Medical Review Series 

thank you baby jesus for this video. These are just amazing review. Thanks Paul for taking the time to do these for the benefit of others in the medical community.

I'm currently in pharmacy school and we were taught that increasing levels of uric acid causes gout. Niacin may cause increased levels of uric acid. So I believe that is why Niacin is not recommended for those with gout.

Thank you very much for you efforts! .. I wished if you included the new monoclonal antibodies "PCSK9 inhibitors" i heared that they started to appear in usmle questions.

thank you for your efforts

Thank you. Great lectures.

god bless you and your efforts

Thank you this was an awesome video!

Perfect Explanation👏🏻👏🏻

Excellent lecture

Monday, October 3, 2022. Cardiology: Hypercholesterolemia (High Cholesterol and/or Triglycerides, LDL, and/or VHDL Levels). Association with 1) Atherosclerosis, 2) Coronary Artery Disease, 3) Myocardial Infarction, and 4) Death; Dx: Cholesterol Level Blood Test (Lipid/Cholesterol Panel) with Two Separate Lipid Panel Abnormalities; Screening Recommendations are q 5 Years from 20 Years of Age onward. Aetiology: 1) Diet (High Consumption of Meats and Eggs, otherwise Animal Products) and 2) Genetics (Familial Hypercholesterolemia [FHC] an Autosomal Dominant and Recessive Inheritance; SSx: Xanthoma Skin Lesions with FHx of Premature CAD); Tx: 1) Low-Fat Diet and/or 2) Medical Treatment with Antilipidemic Agents (Most Common Treatment is HMG CoA Reductase Inhibitors, Statins); Risk Factors (RFs) using the Framingham Cardiac Risk Study Criteria: 1) Nicotine From Smoking Tobacco ("Smoking"); 2) Hypertension (Treated or Untreated), 3) Low High-Density LIpoprotein (HDL) Levels indicating Low Exercise And/or Sedentary Lifestyle Possibly; 4) Family History of Premature CAD (Male < 55Y and Female < 65 y); and 5) Age (Male >45 and Female > 55); Other Risk Factors Possible are 1) Coronary Artery Disease (CAD), 2) Peripheral Artery Disease (PAD), 3) Abdominal Aortic Aneurysm (AAA), and 4) Diabetes Mellitus (DM); Pharmacology of Antihyperlipidemics and Drug Classes: 1) HMG CoA Reductase Inhibitors (Association of an Increased Survival) commonly known as Statins (Atorvastatin Most Common Prescribed Medication in the History of Pharmacology) is known to Lower Biosynthesis of Cholesterol and primarily Lowering LDL. Statins are First Line Treatment for Dyslipidemia/Hypercholesterolemia. Pregnancy (Teratogenic) and Liver Disease (Increase Liver Enzymes) Contraindication/Niacin and Fibrate Concomitant (Rhabdomyolysis And/or Myalgia). When Warfarin is Relevant INR Monitoring is Indicated to check For ADRs and may warrant Warfarin Dosage Adjustments; 2) Fibrates (Primarily for Lowering Triglycerides due to Increasing of Lipoprotein Lipase), 3) Niacin (Niacinamide or Vitamin B 3 for HDL Increases) are known to cause 1) Flushing, 2) Pruritus, 3) Gout Aggravation and are CI in 1) Liver Disease and 2) Severe Peptic Ulcer Disease (sPUD). Niacin is ideal for Refractory Low Level of HDL; 4) Bile Acid Sequestrants for Lowering Low-Density Lipoprotein (LDL Level and the Most Concerning Lipid). The Mechanism of Action (MOA) is Bile Acid Reuptake (Reabsorption) in the Small Intestine. Side Effects (SEs) are 1) Flatulence/Bloating, 2) Dyspepsia/GI Upset, and 3) Steatorrhea (Foul Stools); and 5) Ezetemibe is Indicated for increasing the Cellular Absorption of Cholesterol when combined with a Statin (MOA: Intestinal Lumen Cholesterol Transporter Antagonism) and is touted as an Effective Cholesterol Reduction Adjuvant (Coupled with a Statin) and Producing few if any Side Effects or ADRs. This Agent is CI in Patients with Severe Hypertriglyceridemia; All Dyslipidemia Agents are Contraindicated in Pregnancy (Exercise and Low Fat Diet is otherwise the Alternative or First LIne Treatment of Dyslipidemia/Hypercholesterolemia in a Gestating Female). Goodness, such a Bonanza these Pharmaceutics have been and the glaring and absurd Irony of The American Craze for Fat only to have a High Morbidity/Mortality for-Purchase as an Economic Model. MD Paul Bolin, es geht sehr gut zu lernen und Lehren mit Ihnen. Ich hoffe es ahnlich fur Dich es. Heil!

Thank you .

God bless you.

Thank you so much doctor. I just have one comment on high LDL causes, is HYPO or HYPER thyroid cause it? bcz I read that hyperlipidemia(high LDL) is classic feature of HYPOthyroidism. Thanks again.

Actually kids are tested beginning on there 12 year old visit. Adults are tested yearly at their annual wellness exam.

Very nice!

Great presentation. Engaging.

You did not mention about Non HDl / chol ratio which is important. What us normal range. And when to start therapy

U r my hero

Hyperthyroidism surely causes many symptoms and risks, but LDL is typically lower in hyperthyroidism than euthyroid.

thank you very much for your videos. my question is "what if a patient on diet and exercise for high LDL, but not high enough to start meds, couldn't achieve the desired LDL level. do we start drug therapy?"

2 videos today, oh yeah.

Screening start at age 35 for men and 45 for women with no risk

Question stems for review for Step1 and Step2

What if a patient cannot tolerate statins? What can be an alternative?

5.38 hypothyroidism?

HIGH LDL, in HYPERTHYROIDISM,? isnt it wrong ? it should be HYPOTHYROIDISM