ChemPath - Lipoprotein metabolism Flashcards

1
Q

What are the types of lipoprotein metabolism disorders

A

Primary hypercholesterolaemia
Primary hypertriglyceridaemia
Primary mixed hyperlipidaemia
Hypolipidaemia

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2
Q

What are the types of Primary Hypercholesteraemia and what is the associated pathology

A

Familial hypercholesteraemia:
- AD: LDLR, apoB, PCSK9
- AR: LDLRAP1
Polygenic hypercholesteraemia: several polymorphisms
Familial hyper(a)-lipoproteinaemia: CETP deficiency
Phytosterolaemia: ABC G5 & G8

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3
Q

What are the types of primary hypertriglyceridaemia and what are the associated pathologies

A

Familial type I: lipoprotein lipase of apoC II deficiency
Familial type V: apoA V deficiency
Familial type IV: increased synthesis of TG

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4
Q

What are the types of primary mixed hyperlipidaemia

A

Familial combined hyperlipidaemia
Familial dys(b)lipoproteinaemia
Familial hepatic lipase deficiency

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5
Q

What are the causes of hypolipidaemia and what are the associated pathologies

A

(A)(B)lipoproteinaemia: MTP deficiency
Hypo(B)lipoproteinaemia: truncated apoB protein
Tangier disease: HDL deficiency
Hypo(a)lipoproteinaemia: apoA-I mutations

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6
Q

What are the types of lipoprotein in order of density

A

Chylomicron (least)
Free fatty acid
very low density lipoprotein
Low density lipoprotein
Intermediate density lipoprotein
High density lipoprotein

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7
Q

What is the role of PCSK9 in lipoprotein metabolism

A

Binds LDLR and promotes its degradation
Loss of function mutation of PCSK9 → lower LDL levels
Novel form of LDL-lowering therapy is Anti-PCSK9 MAb

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8
Q

What is the management for hyperlipidaemia

A

First line: lifestyle (dietary modification and exercise)
Second line: Statin therapy
Third line: ezetimibe

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9
Q

What is the management for obesity

A

First line: conservative (Exercise and diet)
Second line: none for sustained weight loss
- Orlistat
Third line: bariatric surgery

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10
Q

What is the MOA for statins and what are the side effects

A

HMG-CoA reductase inhibitor
Reduces intrinsic synthesis of cholesterol in the liver
Side effects – myopathy/rhabdomyolysis, fatigue

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11
Q

What is the MOA of Orlistat and what are the side effects

A

Pancreatic lipase inhibitor
SE: profound flatus, diarrhoea

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12
Q

What is rimonabant

A

Cannabinoid antagonist
Discontinued due to high risk of suicide

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