cholesterol

Question 1

cholesterol ester and Tg make up what part of apolipoproteins

Answer 1

nonpolar core

Question 2

phospholipid and free cholesterol make up what part of apolipoproteins

Answer 2

polar surface coat

Question 3

between VLDL and chylomicrons, which is atherogenic

Answer 3

VLDL is somewhat atherogenic while chylomicrons are NOT

Question 4

name 2 atherogenic lipoproteins? which one is the main one?

Answer 4

• IDL
• LDL– main one

Question 5

what regulates hepatic cholesterol synthesis

Answer 5

HMG-CoA reductase

Question 6

autosomal dominant condition where there is deficient or defective hepatic LDL receptors causing elevated total & LDL from birth

Answer 6

familial hypercholesterolemia (FH)

Question 7

which familial lipid d/o do you see tendon xanthoma, xanthelasmas, arcus corneus

Answer 7

FH (familial hypercholesterolemia)

Question 8

which familial d/o do you see cardiac events in the 3-4th decade of life in heterozygous

Answer 8

familial hypercholesterolemia

Question 9

varying LDL and VLDL in families w/ high apo B-100 levels

Answer 9

familial combined hyperlipidemia

Question 10

why is familal combined hyperlipidemia hard to diagnose

Answer 10

because 1/3 hs increased LDL, 1/3 has increased TG and 1/3 has both

Question 11

why does familial combined hyperlipidemia have increased atherogenicity (3)

Answer 11

small & dense LDL (can get through vessels and can block path)
cholesterol enriched VLDL
low less anti-inflammatory HDL

Question 12

arcus corneus common and lipid abnormalities AFTER ADOLESCENCE

Answer 12

familal combined hyperlipidemia

Question 13

which familial d/o is commonly associated with HTN, T2DM, obesity?

Answer 13

familial combined hyperlipidemia

Question 14

hypothyroidism, obstructive liveer dz and diuretic use are 3 unique causes of what secondary lipid d/o?

Answer 14

secondary hypercholesterolemia

Question 15

alcohol, estrogen, beta blockers & diuretics are 4 unique causes of what secondary lipid d/o?

Answer 15

secondary hypertriglyceridemia

Question 16

beta blockers, progestin, anabolic steroid use are 3 unique causes of what secondary lipid d/o?

Answer 16

secondary hypoalphalipoproteinemia

Question 17

TG >500-1000; usually acquired but can be genetic

Answer 17

chylomicronemia syndrome

Question 18

main risk of chylomicronemia syndrome? why?

Answer 18

pancreatitis d/t hyperviscosity

Question 19

fatigue, impaired cognition and memory, paresthesias, hepatosplenomegaly are sx of what lipid d/o?

Answer 19

chylomicronemia syndrome

Question 20

finding eruptive xanthomata, lipemia retinalis on PE is associated with which lipid d/o?

Answer 20

chylomicronemia syndrome

Question 21

you do a NON-fasting lipid panel and TG comes back over 400, what do you do?

Answer 21

repeat as fasting

Question 22

4 dietary recommendations to reduce LDL

Answer 22

1. reduce cholesterol to < 200mg/day
2. reduce SFA and TFA to < 5-6% calories
3. add psyllium/soluble fiber
4. add plant stanol/sterol margarines

Question 23

first line action to reduce TG

Answer 23

achieve healthy weight to reduce insulin resistance

Question 24

2 things that inhibits LPL

Answer 24

• alcohol (acutely)
• simple carbs & sweets (also increases VLDL production)

Question 25

effect of omega-3 PUFAs (DHA, EPA) on lipids

Answer 25

less TG synthesis

Question 26

what is normal LDL in gen pop vs high risk/ASCVD

Answer 26

• LDL < 130 general population
• goal often < 70 for those with ASCVD or high risk

Question 27

what is normal HDL for men vs women

Answer 27

• HDL >40 for men
• > 50 for women

Question 28

what is normal TG goal?

Answer 28

TGs < 150