Classification of Lipid Disorders

Question 1

What’s the most common type of Lipid disorder in the US?

a. I
b. IIa
c. IIb
d. III
e. IV

Answer 1

c. IIb

Question 2

What are the primary components of Type IIb hyperlipidemia? (2)

Answer 2

Elevated LDL and VLDL (TG)

Question 3

What is the primary risk of severely elevated TG (500-1000)

Answer 3

Pancreatitis

Question 4

What health conditions is Type IIb associated with (2)?

Answer 4

CHD (atherosclerotic plaque associated with High TG and LDL)

Metabolic Syndrome/Insulin Resistance

Question 5

What is the general pathophys of Type IIa hyperlipidemia? (4 points)

Answer 5

Absent or non-functioning LDL receptors on liver

a) can’t extract LDL from circulation so plaque is deposited on organs and vessels
b) quickly progressive
c) causes EARLY life CHD, MI, stroke, early death

Question 6

What is the typical lipid profile in T1D (TG, LDL, HDL)?

Answer 6

Varies based on glycemic control. Usually:

High TG
High LDL
Low HDL

if uncontrolled

Question 7

What is the typical lipid profile in T2D TG, LDL, HDL)?

Answer 7

Varies based on glycemic control. Usually:

High TG
Low HDL
Smaller than normal LDL (clogs and builds easier, causing earlier vascular disease)

Question 8

What is the primary cause of increased TG in T2D?

Answer 8

Uncontrolled blood sugar

Question 9

What are the main subclasses of lipoproteins? (4)

Answer 9

HDL
LDL
VLDL (TG containing)
Chylomicrons

Question 10

What is the formula for quickly estimating VLDL?

Answer 10

VLDL=TG/5

*TG divided by 5

Question 11

How does VLDL ‘create’ elevated TG? (2)

Answer 11

1) VLDL made by the liver and released into the bloodstream
2) VLDL primarily carry TG to the tissues

*LDL only carries cholesterol to tissues

Question 12

What is the other name for Type IIa Hyperlipidemia?

Answer 12

Familial Hyperlipidemia

Question 13

Which Lipoproteins make up the Apo B? (2)

Answer 13

LDL
VLDL

(non-HDL)

Question 14

When assessing lipid profiles, when should you consider the presence of metabolic syndrome/insulin resistance?

Answer 14

TG/HDL ratio over 4/5

Question 15

What lipoproteins can increase when treating high TG?

Answer 15

LDL

Question 16

When there is an increase in LDL when treating high TG, what happens to HDL?

Answer 16

Clearance of HDL increases

8When LDL is small and Tg is high, HDL isn’t able to remove cholesterol from tissue

Question 17

What lab values are most accurate for evaluating a patient lipid profile? (2)

Answer 17

Apo B

Lipo protein density

Question 18

Explain the process of hyperlipidemia in relation to uncontrolled blood sugars? (7)

Answer 18

1) Glucose converted to glycogenin
2) Glycogenin increases output of VLDL (Hepatic output of TG)
3) Increased output of VLDL causes instability of LDL (converts to small/dense LDL)
4) Small/dense LDL penetrates the vascular lining
5) Vascular penetration of LDL causes increased atherosclerotic disease
6) Increased atherosclerotic disease lessens the ability for HDL to reverse transport cholesterol
7) Decreased reverse transport of cholesterol further increases atherosclerotic disease.