Atherosclerosis and Hyperlipidemia

Question 1

Following a meal, lipids are digested and absorbed in the GI tract for transport to the liver. Which of the following blood components transports exogenous (dietary) triglyceride from the intestine to the liver?

a. Lipoprotein lipase
b. Chylomicrons
c. High density lipoprotein
d. Low density lipoprotein
e. Oxidized low density lipoprotein

Answer 1

b. Chylomicrons

Question 2

Gross and microscopic pathologic findings of autopsy studies reveal that atheroma formation can start in early childhood. Which of the following lesions is most likely to be the first (earliest) visible gross evidence for the formation of an atheroma?

a. Calcification
b. Thrombus
c. Fatty streak
d. Hemorrhage
e. Ulceration

Answer 2

c. Fatty streak

Question 3

Which of the following apoproteins is required for cell surface recognition of LDL by the LDL receptor?

a. Apo A-1
b. Apo B-48
c. Apo B-100
d. Apo C-2
e. Apo E

Answer 3

c. Apo B-100

Question 4

Assuming all other risk factors for AS/CAD are normal, which of the following risk factor changes from normal blood levels increases the risk for a patient to develop AS/CAD?

a. Postprandial increased triglyceride
b. Increased HDL
c. Decreased LDL
d. Increased Lp (a)
e. Decreased high sensitivity CRP

Answer 4

d. Increased Lp (a)

Question 5

What is atherosclerosis?

Answer 5

AS is a disease of formation and growth of intimal lesions (atheromas) which protrude into and obstruct vascular lumens as well as weaken the underlying media.

Question 6

What is a major risk factor for atherosclerosis?

Answer 6

Hypercholesterolemia

Question 7

What are major non-modifiable risks for atherosclerosis?

Answer 7

Age
Male gender
Family history
Genetic abnormalities

Question 8

What is the role of homocysteine in AS?

Answer 8

May contribute to AS through:
• Platelet activation and increasing platelet adhesiveness
• Promoting proinflammatory response, DVT and directly activates coagulation cascade
• Causing endothelial dysfunction and SMC proliferation
• Enhancing LDL oxidation and deposition

Question 9

What is the role of Lp(a) in AS?

Answer 9

• LDL particle with apo-B100 linked to apo (a) that may inhibit fibrinolysis which links hyperlipidemia to abnormal coagulation

Question 10

What is the role of high sensitivity CRP?

Answer 10

• CRP a long known marker of chronic inflammation

* Elevated levels may indicate greatest risk for CVD

Question 11

What are predictive factors used to predict 10 year CAD risk?

Answer 11

• Age
• Diabetes
• Smoking
• Blood pressure categories
• NCEP total cholesterol categories
• LDL cholesterol categories