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ELM2 - pathology > chempath tutorial 2 - lipids & lipoproteins > Flashcards

chempath tutorial 2 - lipids & lipoproteins Flashcards

1
Q

What are the most abundant lipids in the plasma?

A

Triglycerides

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2
Q

Where are triglycerides synthesised?

A

The liver

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3
Q

How are endogenous triglycerides primarily transported in the plasma?

A

Via VLDL

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4
Q

What is the metabolic fate of triglycerides?

A

They will circulate in the plasma until energy is required, then they will be broken down into fatty acids and glycerol for energy via the process of lipolysis

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5
Q

How are exogenous triglycerides primarily transported in the plasma?

A

Via chylomicrons

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6
Q

What are endogenous lipoproteins?

A

Lipoproteins created from dietary lipids

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7
Q

What are exogenous lipoproteins?

A

Lipoproteins synthesised by the liver

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8
Q

Which lipoprotein is the precursor to LDL?

A

IDL

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9
Q

What are the components of a typical lipoprotein?

A

Lipids (apolar), lipid surface phospholipids (polar), apoproteins

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10
Q

How are fatty acids transported in the plasma?

A

Bound to plasma proteins such as albumin

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11
Q

Which lipoprotein has the highest proportion of proteins?

A

HDL

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12
Q

Which lipoprotein has the highest proportion of cholesterol?

A

LDL

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13
Q

What appearance would you expect of a plasma sample refrigerated overnight of a patient with raised chylomicrons?

A

Thick cream layer on the top of the sample

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14
Q

What appearance would you expect of a plasma sample refrigerated overnight of a patient with elevated VLDL?

A

Cloudiness (turbidity) due to elevated TAGs

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15
Q

What appearance would you expect of a plasma sample refrigerated overnight of a patient with raised LDL?

A

Sample will appear normal, but may have an orange tint

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16
Q

What appearance would you expect of a plasma sample refrigerated overnight of a patient with elevated IDL?

A

Usually a thin cream layer on top of sample due to presence of chylomicron remnants, and usually a degree of cloudiness/turbidity

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17
Q

What appearance would you expect of a plasma sample refrigerated overnight of a patient with elevated HDL?

A

There are no changes to the serum if HDL is raised, because it contains mostly proteins so will not rise to the top, and it does not generate turbidity

18
Q

Which lipoprotein levels are likely to raised in plasma sample with elevated total cholesterol but no elevation in TAG?

A

LDL

19
Q

Which lipoprotein levels are likely to raised in plasma sample with elevated total cholesterol and elevated TAG?

A

IDL, VLDL

20
Q

Which lipoprotein levels are likely to raised in plasma sample with elevated TAG but normal cholesterol?

A

Chylomicrons

21
Q

What is the abnormality in lipoprotein metabolism in diabetes mellitus?

A

Insulin resistance results in increased TAG synthesis in the liver, resulting in elevated VLDL circulation. Also will see decreased HDL.

22
Q

What is the abnormality in lipoprotein metabolism in hypothyroidism?

A

Increases LDL levels by increasing cholesterol, and can also down-regulate LDL receptors, further increasing LDL concentration in the plasma.

23
Q

What is the abnormality in lipoprotein metabolism in nephrotic syndrome?

A

Nephrotic syndrome involves the loss of proteins, including apoprotein B, through the kidneys, which causes elevated LDL and VLDL (which have little protein content), and the loss of HDL (high protein)

24
Q

What is the abnormality in lipoprotein metabolism in cholestasis?

A

Decreased excretion of bile salts into the intestine impairs the absorption of dietary fats, but aggregations of cholesterol form LDL-like aggregations

25
Q

What is the abnormality in lipoprotein metabolism in liver cirrhosis?

A

Liver damage alters the synthesis and/or secretion of lipoproteins, including HDL and VLDL, reducing their levels. Thus, can be issues with TAG clearance if unable to transported via VLDL

26
Q

What lipoproteins are most important in determining a person’s risk of atherosclerosis?

A

HDL cholesterol, LDL cholesterol

27
Q

What does total plasma cholesterol concentration infer about a patient’s risk of developing atherosclerosis?

A

Implies an elevated LDL, which increases risk of atherosclerosis

28
Q

What cholesterol levels decrease the risk of developing atherosclerosis?

A

Low total cholesterol, low LDL cholesterol, high HDL cholesterol

29
Q

What are the 2 key classifications of hyperlipidaemias?

A

Primary (inherited/genetic), Secondary (acquired)

30
Q

What are the clinical characteristics of Familial hypercholesterolaemia?

A

Elevated cholesterol from childhood, early onset of coronary heart disease, early mortality, strong family history

31
Q

What is the most common type of genetic mutation that causes familial hypercholesterolaemia?

A

Mutations causing dysfunction/lack of production of LDL receptors

32
Q

What are the clinical characteristics of Remnant Hyperlipoproteinaemia?

A
  • Presence of excess IDL and chylomicron remnants in the plasma
  • fat deposits in palmar creases, etc.
  • increased risk of CHD/PVD
33
Q

What gene is affected in remnant hyperlipoproteinaemia?

A

apo E gene, with dysfunction causing impaired uptake of IDL by the liver

34
Q

What are the clinical characteristics of familial chylomicronaemia?

A
  • elevated chylomicrons in the blood due to poor clearance
  • xanthomata (fatty depositions)
  • recurrent pancreatitis
35
Q

What genetic abnormality commonly causes familial chylomicronaemia?

A

Lipoprotein Lipase gene leading to enzyme deficiency and insufficient breakdown of cholesterol

36
Q

What are the clinical characteristics of familial hypertriglyceridaemia?

A
  • elevated chylomicrons leading to fatty deposits, i.e. eruptive xanthomata
37
Q

What are the clinical characteristics of familial combined hyperlipidaemia?

A
  • Elevated VLDL and LDL levels
  • Elevated cholesterol and/or TAG levels
  • increased risk of IHD
38
Q

What is the function of Apolipoprotein A?

A

Structural component of HDL

39
Q

What is the function of Apolipoprotein B?

A

Protein found in lipoproteins: chylomicrons, VLDL, IDL and LDL

40
Q

What is the function of Apolipoprotein C?

A

Lipoprotein metabolism, by activating metabolic enzymes, e.g. lipoprotein lipase

41
Q

What is the function of Apolipoprotein E?

A

Metabolism of TAG lipoproteins - chylomicrons and VLDL

ELM2 - pathology (19 decks)

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