cholesterol, atheroma, CHD

Question 1

LDL levels are raised by (3)

Answer 1

cigarette smoking, coffee, stress

Question 2

Majority of cholesterol is

Answer 2

LDL

Question 3

Cholesterol largely responsible for atheroma formation

Answer 3

LDL

Question 4

Cholesterol which prevents atheroma

Answer 4

HDL

Question 5

Functions of cholesterol (6)

Answer 5

lipid precursor for other steroids, important in cell growth and division, regulation of sexual function, regulation of tissue metabolism, mineral balance and formation of bile salts

Question 6

proportion of cholesterol made in liver

Answer 6

1/4

Question 7

cholesterol is poorly absorbed by

Answer 7

gut

Question 8

cholesterol is carried in blood as part of

Answer 8

lipoprotein

Question 9

HDL formation begins in

Answer 9

liver

Question 10

HDL begins as

Answer 10

empty collapsed protein shell

Question 11

HDLs travel in blood picking up

Answer 11

cholesterol and phospholipids

Question 12

After picking up cholesterol and phospholipids, HDL

Answer 12

returns to liver and cholesterol is removed

Question 13

chylomicrons form in

Answer 13

absorptive cells of small intestine

Question 14

chylomicrons travel from small intestine through ….. to blood

Answer 14

lymphatic system

Question 15

chylomicrons are hydrolysed to monoglycerides and free fatty acids to travel through capillary walls into adipocytes before being resynthesised into

Answer 15

triglycerides

Question 16

VLDLs are produced by

Answer 16

liver

Question 17

VLDLs transport lipids to adipose tissue for storage where they become

Answer 17

LDLs

Question 18

liver compensates for …………. of cholesterol

Answer 18

dietary intake

Question 19

changes in diet can reduce serum cholesterol by

Answer 19

5% max

Question 20

Fatty acid intake can reduce cholesterol level by

Answer 20

15-20%

Question 21

2 other forms of synthesis of cholesterol

Answer 21

glycolysis (acetyl CoA) or beta-oxidation of other lipids

Question 22

exercise reduces sensitivity of right atrium to …….. and so heart secretes less …… and blood volume …… meaning more cholesterol is transported by HDLs to …….

Answer 22

blood pressure; atrial natriuretic peptide; increases; liver

Question 23

familial hypercholesterolaemia due to (2)

Answer 23

low number LDL receptors, altered function/structure of receptors

Question 24

familial hypercholesterolaemia is most common type of ……… (1/500)

Answer 24

hyperlipidaemia

Question 25

in familial hypercholesterolaemia, LDL levels are in excess of

Answer 25

190

Question 26

LDL receptor gene on chromosome

Answer 26

19

Question 27

familial hypercholesterolaemia alleles exhibit

Answer 27

incomplete dominance

Question 28

symptoms of familial hypercholesterolaemia (5)

Answer 28

xanthomas, xanthelasmas, arcus senilis, obesity, symptoms of atherosclerosis

Question 29

xanthoma =

Answer 29

fatty, cholesterol-rich deposits in skin

Question 30

xanthelasma =

Answer 30

fatty deposits on eyelid

Question 31

arcus senilis =

Answer 31

white ring around cornea

Question 32

atheroma =

Answer 32

accumulation of intracellular and extracellular lipid in INTIMA of large and medium arteries

Question 33

3 stages of atheroma formation

Answer 33

fatty streak, simple plaque, complicated plaque

Question 34

arteriosclerosis =

Answer 34

thickening of arterial walls, usually due to diabetes / hypertension

Question 35

causes of atherosclerosis (5)

Answer 35

high BP, high cholesterol, smoking, high blood sugar, heart disease - angina

Question 36

risk factors of atherosclerosis (15)

Answer 36

smoking, male, menopause, diet, alcohol, obesity, familial hyperlipidaemia, acquired hyperlipidaemia, diabetes, lack of exercise, type A personality, stress, infection, soft water, oral contraceptives

Question 37

ATHEROMA FORMATION: (1) micelles absorbed into intestinal mucosa > converted to ......

Answer 37

chylomicrons

Question 38

ATHEROMA FORMATION: (2) chylomicrons absorbed by ......... and travel through thoracic duct to be distributed throughout the body

Answer 38

lacteals

Question 39

ATHEROMA FORMATION: (3) ............ .......... hydrolyses chylomicrons into fatty acids and monoglycerides which are released into intestinal fluid to be absorbed by adipocytes and skleletal muscle

Answer 39

lipoprotein lipase

Question 40

ATHEROMA FORMATION: (4) liver absorbs chylomicron and removes triglyceride > combines with ........... (alters surface protein)

Answer 40

cholesterol

Question 41

ATHEROMA FORMATION: (5) Capillary endothelial cells contain LDL receptors and absorb LDLs in .......... coated vesicles

Answer 41

clathrin

Question 42

ATHEROMA FORMATION: (6) Excess levels of cholesterol inhibit cholesterol and LDL receptor synthesis > LDL uptake reduced > cholesterol ......... promoted

Answer 42

storage

Question 43

ATHEROMA FORMATION: (7) Circulatory monocytes remove .......... and become saturated with ............ droplets

Answer 43

lipoproteins; lipid

Question 44

ATHEROMA FORMATION: (8) Saturated monocytes form ..... cells which attach to endothelial walls of blood vessels

Answer 44

foam

Question 45

ATHEROMA FORMATION: (9) Once foam cells attached to endothelial walls of blood vessels, they release cytokines which stimulate stimulate smooth muscle cells near the tunica ............ to divide causing the walls to thicken

Answer 45

intima

Question 46

ATHEROMA FORMATION: (10) Other monocytes invade the area and ........... lipids forming an atherosclerotic ....... and ........

Answer 46

phagocytise; plaque; stenosis

Question 47

LDLs secrete ....... which prevents normal migration of macrophages out of arteries

Answer 47

netrin-I

Question 48

coronary atherosclerosis is a complex ........ process

Answer 48

inflammatory

Question 49

coronary atherosclerosis is the accumulation of lipids, macrophages and ...... ......... cells

Answer 49

smooth muscle

Question 50

ATHEROGENESIS: (1) atherogenesis follows endothelial ........ with increased permeability to and accumulation of .......... lipoproteins

Answer 50

dysfunction; oxidised

Question 51

ATHEROGENESIS: (2) oxidised lipoproteins taken up by macrophages at .......... ..... within endothelium

Answer 51

focal sites

Question 52

ATHEROGENESIS: (3) these macrophages form lipid-laden ..... ...... which form a fatty .....

Answer 52

foam cells; streak

Question 53

ATHEROGENESIS: (4) fatty streak progresses with extracellular lipid within endothelium to form a ............ plaque

Answer 53

transitional

Question 54

ATHEROGENESIS: (5) monocytes, macrophages and damaged endothelium release ..... which promote further accumulation of macrophages and smooth muscle cell migration and ..........

Answer 54

cytokines; proliferation

Question 55

ATHEROGENESIS: (6) collagen is produced in large quantities by ......... .......... and events accumulate finally forming a ......... ........

Answer 55

smooth muscle; fibrolipid plaque

Question 56

There are two mechanisms a thrombosis can develop on a plaque:

Answer 56

superficial endothelial injury, deep endothelial fissuring

Question 57

superficial endothelial injury = denudation of endothelial covering of plaque exposing the subendocardial .... ....... .......... and allowing platelet adhesion due to reaction with .....

Answer 57

connective tissue matrix; collagen

Question 58

deep endothelial fissuring = advanced plaque with ..... core formed because plaque cap tears allowing .... to enter. Core now has lamellar lipid surfaces, ...... ...... produced by macrophages and exposed ..... which makes it highly .....

Answer 58

lipid; blood; tissue factor; collagen; thrombogenic

Question 59

total cholesterol ratio should not exceed

Answer 59

5

Question 60

ideal cholesterol ratio

Answer 60

1.0-3.5

Question 61

when calculating cardiovascular risk, what is cut off for high risk?

Answer 61

20+%

Question 62

when calculating cardiovascular risk, what is cut off for moderate risk?

Answer 62

10-20%

Question 63

when calculating cardiovascular risk, what is cut off for low risk?

Answer 63

<10%