Obstetrics and Gynecology Board Review Pearls of Wisdom

234 Obstetrics and Gynecology Board Review •••

❍ Which test in the lipid profile is continuously correlated with the relative risk of developing CAD?
Low-density lipoprotein (LDL) cholesterol.

40 70 100 130 160 190

LDL Cholesterol (mg/dL)

3.7

2.9

2.2

1.7

1.3

1.0

Relative

Risk for

Heart

Disease

(Log Scale)

❍ What are the main side effects of the cholesterol lowering agents?
Statins (HMG-CoA reductase inhibitors) → Myopathy, increased liver enzymes.
Bile acid sequestrants → Gastrointestinal (GI) distress, constipation, decreased absorption of other medications.
Nicotinic acid → Flushing, hyperglycemia, gout, upper GI distress, hepatotoxicity
Fibric acids → Dyspepsia, gallstones, myopathy.

❍ What are lifestyle factors that increase the risk of atherosclerosis?
Inactive lifestyle, cigarette smoking, and obesity.

❍ How does exercise improve the lipid profile?
Exercise increases the high-density lipoprotein (HDL) component.

❍ How does smoking affect the lipid profile?
Smoking decreases the HDL component.

❍ At what age should one be screened for diabetes?
Beginning at age 45, and repeated every 3 years, unless the patient is considered high risk.