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MTAP 2 FINALS > CLINICAL CHEMISTRY LIPIDS > Flashcards

CLINICAL CHEMISTRY LIPIDS Flashcards

1
Q

Lipids are composed of mostly

A

C-H bonds

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2
Q

Lipids are commonly reffered to as

A

fats

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3
Q

Lipids are source of

A

Fuel

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4
Q

Lipids are insoluble to

A

blood or plasma

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5
Q

Lipids are soluble to

A

organic solvents

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6
Q

Classifications of Lipids:

A

Fatty acids, Triglycerides, Cholesterol, Phospholipids, Fat-soluble vitamins (A,D,E,K)

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7
Q

Lipids are transported by:

A

Lipoproteins (VLDL, LDL, HDL)

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8
Q

Linear chains of C-H bonds that terminates with -COOH

A

Fatty Acids

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9
Q

constituents of phospholipids or triglycerides

A

Fatty Acids

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10
Q

derived from the hydrolysis of triglycerides in the adipose tissue

A

Fatty Acids

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11
Q

substance for the conversion of glucose for gluconeogenesis

A

Fatty Acids

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12
Q

Fatty acids bound to albumin are ____

A

unesterified

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13
Q

Fatty acids constituent of triglycerides or phospholipids __

A

esterified

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14
Q

short fatty acids chain number:

A

4-6

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15
Q

medium fatty acids chain:

A

8-12

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16
Q

long chain of fatty acids:

A

> 12

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17
Q

fatty acids with no double bonds

A

saturated

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18
Q

fatty acids with one double bond

A

monosaturated

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19
Q

fatty acids with greater than or equal to double bond

A

polyunsaturated

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20
Q

Classification of fatty acids: butyric acid

A

saturated

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21
Q

Classification of fatty acids: oleic acid

A

monosaturated

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22
Q

Classification of fatty acids: linoleic acid

A

polyunsaturated

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23
Q

Classification of fatty acids: glycerol

A

saturated

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24
Q

Also known as neutral fat

A

triglyceride

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25
Q

triglyceride contains —– fatty acids attached to one molecule of glycerol

A

three fatty acids

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26
Q

Contains saturated fatty acids or unsaturated fatty acids; veryhydrophobic

A

triglycerides

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27
Q

No charged groups, water insoluble, neutral lipid

A

triglyceride

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28
Q

Main storage of lipid in man

A

triglycerides

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29
Q

triglycerides are mainly found in

A

adipose tissues

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30
Q

triglycerides percentage of stored fat in body

A

95%

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31
Q

Predominant form of triglyceride in plasma

A

glyceryl ester

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32
Q

Provides insulation

A

Lipid - Triglycerides

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33
Q

Enzyme for breaking down lipids

A

Lipoprotein Lipase (LPL)

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34
Q

hormone for lipid breakdown

A

epinephrine and cortisol

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35
Q

Also known as conjugated lipids

A

phospholipids

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36
Q

Phospholipids contains

A

two fatty acids attached to one molecule of glycerol

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37
Q

phospholipid head group location

A

third position (phosphorylated end)

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38
Q

Hydrophilic end of phospholipid location

A

outer part

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39
Q

Hydrophobic end of phospholipid location

A

Inner

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40
Q

Most abundant lipid in the body

A

phospholipids

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41
Q

Phospholipids are derived from

A

phosphatidic acid

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42
Q

Origin of phospholipids

A

liver and intestines

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43
Q

Not part of the lipid profile; not routinely measured

A

phospholipids

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44
Q

Phospholipids are only measured in

A

Fetal Lung Maturity

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45
Q

Fetal lung maturity collection

A

amniotic fluid and phospholipids

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46
Q

Surfactants of phospholipids

A

Sphingomyelin and lecithin ratio

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47
Q

Three forms of phospholipids: Major form of phospholipids (70%)

A

Lecithin or Phosphatidyl Choline

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48
Q

Three forms of phospholipids: constitutes about 20%

A

Sphingomyelin

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49
Q

Three forms of phospholipids: Constitutes about 10%

A

Cephalin

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50
Q

Also known as 3-hydroxy-5, 6 Cholestene

A

Cholesterol

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51
Q

Unsaturated steroid alcohol contains four rings, component of steroids

A

Cholesterol

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52
Q

amphiphatic lipids

A

Cholesterol and Phospholipids

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53
Q

Important constituent in the assembly of cell membrane
and bile acid (as precursor)

A

Cholesterol

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54
Q

contributes to the metabolism or digestion
of fats in the intestine

A

Bile acid

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55
Q

Lipid that does not serve as fuel of energy of the cells

A

Cholesterol

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56
Q

Unesterified cholesterol: amphiphatic; 30% of the total cholesterol in the body; Present in the plasma or serum, and RBCs; Polar type

A

Free cholesterol

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57
Q

Esterified cholesterol: neutral lipid; 70% of the total cholesterol in the body; also present in plasma or serum; hydrophobic form

A

Cholesterol ester

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58
Q

Important enzyme for esterified cholesterol

A

LCAT: Lecithin-Cholesterol Acyl Transferase

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59
Q

catalyzes the esterification of cholesterol by promoting the transfer of fatty acids from lecithin to cholesterol

A

LCAT: Lecithin-Cholesterol Acyl Transferase

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60
Q

activator for LCAT

A

APO A-I

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61
Q

Promotes fat absorption in the intestine

A

bile salts

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62
Q

cholesterol converted to steroid hormones:

A

glucocorticoids, mineralocorticoid; estrogen

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63
Q

Cholesterol converted to vitamin (absorption of calcium)

A

Vitamin D

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64
Q

Lipid profile test involves:

A

TAG,Lipoproteins (HD:, LDL, VLDL), Total cholesterol

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65
Q

Directly measured with reagent in Lipid profile test

A

TAG (triglycerides); cholesterol

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66
Q

Directly measured with reagent and machine in lipid profile test

A

HDL

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67
Q

Not directly measured with reagent, these are calculated/computed in Lipid Profile

A

LDL and VLDL

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68
Q

essential or important in the diagnosis of lipoprotein diseases and management of lipoprotein disorders and lipid abnormalities

A

Cholesterol

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69
Q

Components of Lipoprotein structure

A

both lipids and proteins (apolipoproteins)

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70
Q

Composition of Lipoprotein structure on the surface (hydrophilic)

A

Free cholesterol, phospholipids

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71
Q

Composition of Lipoprotein structure found in the core regions (hydrophobic)

A

Triglycerides and cholesteryl esters

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72
Q

Characteristics Functions of Apolipoproteins

A

Highly stable
Ligands for cell receptor
activators and inhibitors of enzymes
amphipathic

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73
Q

Apolipoprotein: Apo A-I and A-II
Major LPP location

A

HDL

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74
Q

Function: LCAT activator, ABCA1, lipid acceptor
Apolipoprotein:

A

APO A-I

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75
Q

Function: Inactivates LCAT ; Apolipoprotein:

A

Apo A-II

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76
Q

Apolipoprotein: Apo B-100 ; Major LPP location

A

LDL, VLDL

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77
Q

Apolipoprotein: Apo B-48 ; Major LPP location

A

Chylos

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78
Q

Apolipoprotein: Apo- IV, C-I, C-II, C-III ; Major LPP location

A

Chylos, VLDL, HDL

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79
Q

Apolipoprotein: Apo E ; Major LPP location

A

VLDL, HDL

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80
Q

Apolipoprotein: Apo(a) ; Major LPP location

A

Lp(a)

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81
Q

Function: LDL receptor ligand ; Apolipoprotein:

A

Apo B-100, Apo E

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82
Q

Function: remnant receptor ligand ; Apolipoprotein:

A

Apo B-48

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83
Q

Function: LPL cofactor ; Apolipoprotein:

A

Apo C-II

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84
Q

Function: LPL inhibitor ; Apolipoprotein:

A

Apo C-III

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85
Q

Function: Plasminogen inhibitor ; Apolipoprotein:

A

Apo(a)

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86
Q

Major types of lipoproteins

A

Chylomicrons, VLDL, LDL, HDL

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87
Q

Heaviest lipoprotein

A

HDL

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88
Q

Major protein of chylomicrons

A

Apo B-48

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89
Q

Major protein of VLDL and LDL

A

Apo B-100

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90
Q

Major protein of HDL

A

Apo A-I

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91
Q

Total lipid (% by weight) 98%

A

Chylomicrons

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92
Q

Total lipid (% by weight) 89-96

A

VLDL

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93
Q

Total lipid (% by weight) 77%

A

LDL

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94
Q

Total lipid (% by weight) 50%

A

HDL

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95
Q

Triglyceride (% by weight) 84%

A

Chylomicrons

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96
Q

Triglyceride (% by weight) 44-60%

A

VLDL

97
Q

Triglyceride (% by weight) 11%

A

LDL

98
Q

Triglyceride (% by weight) 3%

A

HDL

99
Q

Largest and least dense lipoprotein

A

chylomicrons

100
Q

Major transporter of exogenous triglycerides

A

chylomicrons

101
Q

Chylomicrons are produced in

A

intestines

102
Q

Exogenous triglyceride transports

A

dietary lipids to hepatic and peripheral cells

103
Q

Chylomicrons are completely cleared from plasma or circulation within

A

6-9 hours post-prandial

104
Q

Fasting required for lipid profile testing

A

12 hours

105
Q

Chylos present in blood causes —- in lipid profile

A

false increased

106
Q

Lipid profile is done to determine

A

normal metabolism

107
Q

Lipid and Glucose Tests fasting hours:

A

10 hours

108
Q

Also known as pre-beta lipoprotein

A

very low density lipoproteins

109
Q

Electrophoresis location of VLDL

A

pre-beta region

110
Q

VLDL is produced in

A

liver and intestines

111
Q

Endogenous pathway:

A

Transfer triglycerides from the liver to peripheral tissues

112
Q

Also known as beta lipoprotein or bad cholesterol

A

Low density lipoprotein

113
Q

Electrophoresis location of LDL

A

beta region

114
Q

Most cholesterol rich; most atherogenic lipoprotein

A

LDL

115
Q

atherogenic: contribute to the formation of Insoluble fatty
plaque of blood flow (obstruction in blood vessel)

A

LDL

116
Q

Formed from lipolysis of VLDL to IDL (intermediate density lipoprotein

A

LDL

117
Q

LDL pathway

A

Exogenous (dietary chole to peripheral)

118
Q

Also known as: Alpha lipoprotein or good cholesterol

A

High density lipoprotein

119
Q

Electrophoresis location of HDL

A

Alpha region

120
Q

HDL is produced in the

A

liver and intestines

121
Q

HDL pathway

A

reverse cholesterol transport mechanism

122
Q

HDL transfers excess cholesterol back to —

A

Liver

123
Q

High HDL relationship to coronary heart disease

A

lower risk for CHD

124
Q

High LDL relationship to coronary heart disease

A

increases the risk for CHD

125
Q

CARDIOPROTECTIVE LIPOPROTEIN

A

HDL

126
Q

Only minor type of lipoprotein; LDL lipoprotein like particle

A

Lipoprotein(a)

127
Q

has a variable migration when subjected to electrophoresis; pre-beta region or between LDL and Albumin region

A

Lipoprotein(a)

128
Q

Confers increased risk for: premature coronary heart disease and stroke

A

Lipoprotein(a)

129
Q

Lipoprotein (a) competes with plasminogen for

A

fibrin

130
Q

Important for fibrinolysis

A

plasminogen

131
Q

Also known as the SINKING PRE-β LIPOPROTEIN

A

Lipoprotein(a)

132
Q

density of lipoprotein(a) is the same as

A

LDL

133
Q

Product of VLDL catabolism

A

INTERMEDIATE DENSITY LIPOPROTEIN (IDL)

134
Q

IDL migration to electrophoresis

A

pre-B or Beta region

135
Q

Abnormal lipoprotein: found in obstructive jaundice
and LCAT deficiency

A

Lipoprotein X (Lpp X)

136
Q

Lipoprotein X (Lpp X) is specific and sensitive indicator for

A

cholestasis

137
Q

lipid content is mostly phospholipid and free cholesterol (90%)

A

Lipoprotein X (Lpp X)

138
Q

Lipoprotein X contains

A

Apo C and albumin

139
Q

Abnormal lipoprotein: known as “abnormally migrating β-VLDL”

A

B-VLDL

140
Q

also known as floating beta lipoprotein

A

B-VLDL

141
Q

has the density of VLDL by ultracentrifugation but
migrates with LDL in the β region during electrophoresis

A

B-VLDL

142
Q

B-VLDL is found in what disease

A

type 3 hyperlipoproteinemia or dysbetalipoproteinemia

143
Q

Rich in cholesterol content than VLDL

A

B-VLDL

144
Q

Adult reference range for lipids: Total cholesterol

A

140-200 mg/dl

145
Q

Adult reference range for lipids: HDL cholesterol

A

40-75 mg/dL

146
Q

Adult reference range for lipids: LDL cholesterol

A

50-130 mg/dL

147
Q

Adult reference range for lipids: triglyceride

A

60-150 mg/dL

148
Q

Conversion factor for total cholesterol

A

0.026 mmol/L

149
Q

Conversion factor for triglyceride

A

0.011 mmol/L

150
Q

Conversion of dietary lipids into more polar (amphipathic) compounds by Pancreatic Lipase

A

Lipid absorption

151
Q

can also be linked to infection, no absorption, problem in lipid absorption (too much fat globules in feces)

A

Steatorrhea

152
Q

Lipid absorption: conversion of triglyceride

A

monoglycerides

153
Q

Lipid absorption: conversion of cholesterol esters

A

free cholesterol

154
Q

Lipid absorption: conversion of phospholipids

A

lysophospholipids

155
Q

Pathway: Chylomicrons: synthesized in the intestine, carrying dietary lipids to the circulation

A

Exogenous pathway

156
Q

Pathway: Triglycerides in the liver: packaged into VLDL, carrying lipids to the circulation

A

Endogenous pathway

157
Q

Pathway: Chylomicrons → chylomicron remnant particles

A

Exogenous pathway

158
Q

Pathway: VLDL is converted into (IDL) by action of LPL and taken up by liver; Half of VLDL is transformed into: LDL for delivery of exogenous cholesterol to peripheral cells

A

Endogenous pathway

159
Q

Pathway: HDL remove excess cholesterol transport pathway deliver cholesterol back to the liver o To recycle unused and excess cholesterol

A

reverse cholesterol transport mechanism

160
Q

Lipid disorders: Deposition of esterified cholesterol in artery wall

A

Arteriosclerosis

161
Q

Lipid disorder: Increased smooth muscle cells, extracellular lipid, calcification, fibrous tissue, macrophages, lymphocytes, fibrin clots, and platelets (plaque)

A

Arteriosclerosis

162
Q

Coronary Artery disease affects

A

heart (angina and MI)

163
Q

Peripheral vascular disease (PVD) affects:

A

arteries in the arms or legs

164
Q

Cerebrovascular disease (CVD) affects

A

vessels of the brain (stroke)

165
Q

Increased cholesterol
Increased LDL, Decreased receptors
Amphipathic, Clear appearance but with high level

A

Hypercholesterolemia

166
Q

Increased Triglycerides; Decreased LPL or Apo C-II VLDL -/→ VLDL remnants; Chylos -/→ Chylos remnants; Highly hydrophobic

A

Hypertriglyceridemia

167
Q

Increased Triglycerides, Cholestero; Increased VLDL and Chylos remnants; Presence of Apo E2/2

A

Combined Hyperlipoproteinemia

168
Q

Other Lipid Disorder: Also known as Type 2-a

A

Familial Hypercholesterolemia

169
Q

Other Lipid Disorder: Also known as Type 3 Hyperlipoproteinemia

A

Familial Dysbetalipoproteinemia

170
Q

Other lipid disorder: Basses-Kornzweig Syndrome

A

Abetalipoproteinemia

171
Q

Other lipid disorder: Lipid Storage Disease

A

Niemann-Pick disease

172
Q

Lipid measurement principle for cholesterol measurement

A

Dehydration and Oxidation of cholesterol to form a colored compound

173
Q

Preparation for cholesterol measurement:

A

2 weeks usual diet; fasting is not strictly implemented

174
Q

Hemolyzed serum causes __ in cholesterol

A

false increased

175
Q

Water contamination effect in cholesterol

A

less accurate

176
Q

Color developer for cholesterol measurement

A

Glacial Acetic acid, acetic anhydride, conc. sulfuric acid

177
Q

Lipid measurement triglyceride requirement

A

12 hours fasting

178
Q

Lipoprotein Measurement tube for research studies

A

EDTA (plasma)

179
Q

Non enzymatic method for cholesterol measurement

A

Abell Kendall

180
Q

Abell Kendall: Cholesteryl esters: hydrolyzed with

A

Alcoholic KOH

181
Q

Abell Kendall: Unesterified cholesterol: extracted with

A

Hexane

182
Q

Non enzymatic method for cholesterol is measured with

A

Liebermann - Buchard reaction
Salowski Reaction

183
Q

Liebermann - Buchard reaction: Cholesterol + sulfuric acid + acetic anhydride -> produces:

A

Green solution (Cholestadienyl Monosulfonic Acid)

184
Q

Salowski reaction for cholesterol produces

A

Red solution (Cholestadienyl Disulfonic Acid)

185
Q

Involves colorimetry - mix, incubate, and measure for Abell Kendall (Non-enzymatic)

A

1-step method

186
Q

involves colorimetry and extraction for Abell Kendall

A

2- step method

187
Q

3 step method for Abell Kendall

A

Colorimetry, Extraction, Saponification

188
Q

4 step method for Abell Kendall

A

Colorimetry, Extraction, Saponification, and precipitation

189
Q

Enzymatic Method for Cholesterol measurement uses

A

Cholesterol oxidase

190
Q

CDC reference method for cholesterol measurement

A

Abell, Levy and Brodie Method

191
Q

1st enzyme for enzymatic method (cholesterol)

A

Cholesteryl esterase

192
Q

2nd enzyme for enzymatic method (cholesterol)

A

Cholesterol oxidase

193
Q

Enzymatic method 3rd enzyme for cholesterol

A

Peroxidase

194
Q

Color produced in cholesterol oxidase method

A

quinoneimine dye

195
Q

TRIGLYCERIDE MEASUREMENT: non-enzymatic method measures

A

glycerol

196
Q

Product of Glycerol + Periodic acid (triglyceride measurement)

A

Formaldehyde

197
Q

Colorimetric measurement for triglyceride

A

Van Handel and Zilversmith

198
Q

Van handel and Zilversmith: Formaldehyde + Chromotropic acid product

A

Blue solution

199
Q

Principle of Hantzch Condensation

A

Fluometric

200
Q

Hantzch Condensation: Formaldehyde + Diacetyl acetone + NH3 → produces ___

A

Yellow solution

201
Q

Enzymatic Method for triglyceride

A

Glycerol kinase

202
Q

Product of glycerol + ATP – glycerokinase–>

A

Glycerophosphate + ADP

203
Q

Pyruvate kinase for triglyceride: ADP + PEP (phosphoenolpyruvate) –Pyruvate kinase → product

A

ATP + Pyruvate

204
Q

Triglyceride measurement: Pyruvate + NADH + H+ - LD → product

A

Lactate + NAD (measured at 340 nm)

205
Q

Triglyceride measurement: Glycerol-Phosphate Oxidase measures

A

color of end product

206
Q

CDC reference method for Triglyceride

A

Modified Van Handel and Zilversmith

207
Q

Lipoprotein measurement general methods:

A

Ultracentrifugation and Electrophoresis

208
Q

Reference method for the quantitation of lipoproteins

A

Ultracentrifugation

209
Q

Lipoprotein measurement: Ultracentrifugation of plasma is done for

A

24 hours

210
Q

Lipoprotein measurement by ultracentrifugation is measured by

A

molecular density

211
Q

Principle of ultracentrifugation: The density of the lipoprotein is compared with the density of the

A

Potassium bromide

212
Q

Density of potassium bromide

A

1.063

213
Q

Order from lightest to heaviest lipoprotein in ultracentrifugation

A

Chylomicrons
VLDL
LDL
HDL

214
Q

Lipid stains for Electrophoresis of lipoproteins

A

Oil red O, Fat Red 7B and Sudan
black

215
Q

Electrophoresis: 4 bands with fat stains: fastest

A

alpha lipoprotein (HDL)

216
Q

Electrophoresis: 4 bands with fat stains: Pre-beta

A

VLDL, LP(a)

217
Q

Electrophoresis: 4 bands with fat stains: Beta

A

LDL

218
Q

Electrophoresis: 4 bands with fat stains: stationary at origin

A

chylomicrons

219
Q

Most sensitive supporting medium for lipoprotein electrophoresis:

A

agarose gel

220
Q

High-Density Lipoprotein (HDL) Methods: precipitated with polyanions (e.g. Heparin, dextran sulfate or Na phosphotungstate) in the presence of divalent cations (e.g. Mg or Mn), which are sediment by centrifugation (10-30 min. for 10,000g or 3 min. for 15,000g

A

Polyanion precipitation

221
Q

HDL is quantified in the supernate by:

A

Abell kendall (total cholesterol assay)

222
Q

Low-Density Lipoprotein (LDL) Methods: Friedwald formula for VLDL mg/dL

A

VLDL= Triglyceride / 5 = mg/dL

223
Q

Low-Density Lipoprotein (LDL) Methods: Friedwald formula for VLDL mmol/L

A

VLDL= Triglyceride / 2.175 = mmol/L

224
Q

Ultracentrifugation of serum at native density gradient of ____ to float VLDL

A

1.006 g

225
Q

LDL formula

A

Total cholesterol - (HDL + VLDL)

226
Q

Apolipoprotein methods for testing

A

✓ Immunonephelometry
✓ Immunoturbidimetric Assay
✓ Immunochemical Method

227
Q

apolipoprotein for determination of LDL and VLDL conc.

A

Apo B

228
Q

Apolipoprotein for determination of HDL conc.

A

Apo A-I

229
Q

Positive risk factor age for men (CHD)

A

> or = to 45

230
Q

Positive risk factor age for women (CHD)

A

> or = to 55 (premature menopause)

231
Q

Hypertension BP measurement

A

BP > or = to 140/90 mmHg

232
Q

Lipoprotein effect to CHD: HIGH LDL; LOW HDL

A

Increased risk

233
Q

LDL cholesterol concentration: > or = 160mg/dL

A

= or <1 RF

234
Q

LDL cholesterol concentration: > or = 130mg/dL

A

= or >2RF

235
Q

LDL cholesterol concentration: >= 100 mg/dL

A

with CHD or equivalent

236
Q

Diabetes mellitus = CHD risk equivalent due to

A

active lipolysis that is not converted to glucose

237
Q

Negative risk factor for CHD: HDL cholesterol concentration

A

> or = to 60mg/dL

238
Q

Negative risk factor for CHD: LDL cholesterol concentration

A

<100mg/dL: LOW

239
Q

Healthy fats to prevent CHD

A

Omega-3 or Omega- 6

MTAP 2 FINALS (4 decks)

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