4B anatomy physiology and pathology of the small intestine p2 Flashcards
once the chylomicrons enter the lymphatic circulation, they are transported upward through the ______ ____
thoracic duct
how are chylomicrons emptied from mymphatic circulation
Into the venous circulation, vie the Jugular and subclavian veins
_______ usually occurs within an hour after eating a fatty meal
lipemia
what is the avarage half life of a chylomicrons, and what implications does this cause
half life <60min, which means the plasma becomes clear within a few hours
where are chylomicrons removed from the blood
when they pass through the capillaries of the adipose tissue and the liver.
both the adipose tissue and the liver contain large amounts of what protien enzymes
lipoprotein lipase
what are the 5 classes or lipoproteins
chylomicrons
- VLDL
- IDL
- LDL
- HDL
Chylomicrons are synthesized by the _________ of the small intestines, while VLDL, IDL, LDL, HDL are synthesized by ________ _________
enterocytes, liver hepatocytes
VLDL contains
High TGs, moderate cholesterol and phospholipids
IDL contains
Moderate TGs, cholesterol, and phospholipids
LDL contains
Low TGs, high cholesterol and phospholipids
HDL contains
Low TGs, cholesterol and phospholipids
what are the only lipoproteins routinely monitored and used to screen for atherosclerosis, MI and strock risk, heart disease…
LDL-C, and HDL-C
what is the role of LDLs
transport cholesterol and other lipids from the live to the peripheral tissues, making them available for membrane or steroid hormone synthesis
what is the function of HDLs
transport excess cholesterol from peripheral tissues to the liver, where is is broken down and becomes part of the bile
what are the most effective drugs currently in use for treating elevated LDL-c
Statins
_______ refers to muscle pain of weakness without increased creatine kinase, wheras ________ includes elevated CK
myalgia, myositis
what is defined as muscle symptoms,
- very high CK(>10X the normal amount) and
- increased serum creatinine, often with dark urine and myoglobinuria
Rhabdomyolysis
All statins have been associated with ________
Myopathy
what percentage of patients taking statins complain with muscle issues
10%
whare are the risk factors of myopathy (7)
- elderly
- small size
- high statin dose
- liver of renal disease
- diabetes
- controlled hypothyroidism
- interacting medications
what are the three basic preparations of Niacin
- Immediate release
- sastained/extended release
- no-flush
other then reducing the production of VLDL which leads to lowered LDL, what other role does Niacin play
Niacin is the most potent agent for raising HDL levels
what is the average effect of full dose niacin nonotharapy
three effects
- 5-25% reduction in LDL-C
- 15-35% increase in HDL-c
- 20-50% reduction in triglycerides
