4B anatomy physiology and pathology of the small intestine p2

Question 1

once the chylomicrons enter the lymphatic circulation, they are transported upward through the ______ ____

Answer 1

thoracic duct

Question 2

how are chylomicrons emptied from mymphatic circulation

Answer 2

Into the venous circulation, vie the Jugular and subclavian veins

Question 3

_______ usually occurs within an hour after eating a fatty meal

Answer 3

lipemia

Question 4

what is the avarage half life of a chylomicrons, and what implications does this cause

Answer 4

half life <60min, which means the plasma becomes clear within a few hours

Question 5

where are chylomicrons removed from the blood

Answer 5

when they pass through the capillaries of the adipose tissue and the liver.

Question 6

both the adipose tissue and the liver contain large amounts of what protien enzymes

Answer 6

lipoprotein lipase

Question 7

what are the 5 classes or lipoproteins

Answer 7

chylomicrons

• VLDL
• IDL
• LDL
• HDL

Question 8

Chylomicrons are synthesized by the _________ of the small intestines, while VLDL, IDL, LDL, HDL are synthesized by ________ _________

Answer 8

enterocytes, liver hepatocytes

Question 9

VLDL contains

Answer 9

High TGs, moderate cholesterol and phospholipids

Question 10

IDL contains

Answer 10

Moderate TGs, cholesterol, and phospholipids

Question 11

LDL contains

Answer 11

Low TGs, high cholesterol and phospholipids

Question 12

HDL contains

Answer 12

Low TGs, cholesterol and phospholipids

Question 13

what are the only lipoproteins routinely monitored and used to screen for atherosclerosis, MI and strock risk, heart disease…

Answer 13

LDL-C, and HDL-C

Question 14

what is the role of LDLs

Answer 14

transport cholesterol and other lipids from the live to the peripheral tissues, making them available for membrane or steroid hormone synthesis

Question 15

what is the function of HDLs

Answer 15

transport excess cholesterol from peripheral tissues to the liver, where is is broken down and becomes part of the bile

Question 16

what are the most effective drugs currently in use for treating elevated LDL-c

Answer 16

Statins

Question 17

_______ refers to muscle pain of weakness without increased creatine kinase, wheras ________ includes elevated CK

Answer 17

myalgia, myositis

Question 18

what is defined as muscle symptoms,

• very high CK(>10X the normal amount) and
• increased serum creatinine, often with dark urine and myoglobinuria

Answer 18

Rhabdomyolysis

Question 19

All statins have been associated with ________

Answer 19

Myopathy

Question 20

what percentage of patients taking statins complain with muscle issues

Answer 20

10%

Question 21

whare are the risk factors of myopathy (7)

Answer 21

• elderly
• small size
• high statin dose
• liver of renal disease
• diabetes
• controlled hypothyroidism
• interacting medications

Question 22

what are the three basic preparations of Niacin

Answer 22

• Immediate release
• sastained/extended release
• no-flush

Question 23

other then reducing the production of VLDL which leads to lowered LDL, what other role does Niacin play

Answer 23

Niacin is the most potent agent for raising HDL levels

Question 24

what is the average effect of full dose niacin nonotharapy

three effects

Answer 24

• 5-25% reduction in LDL-C
• 15-35% increase in HDL-c
• 20-50% reduction in triglycerides

Question 25

what percentage of patients are able to take a full dose of statins

Answer 25

50-60%