CLINICAL CHEMISTRY LIPIDS Flashcards
(239 cards)
1
Q
Lipids are composed of mostly
A
C-H bonds
2
Q
Lipids are commonly reffered to as
A
fats
3
Q
Lipids are source of
A
Fuel
4
Q
Lipids are insoluble to
A
blood or plasma
5
Q
Lipids are soluble to
A
organic solvents
6
Q
Classifications of Lipids:
A
Fatty acids, Triglycerides, Cholesterol, Phospholipids, Fat-soluble vitamins (A,D,E,K)
7
Q
Lipids are transported by:
A
Lipoproteins (VLDL, LDL, HDL)
8
Q
Linear chains of C-H bonds that terminates with -COOH
A
Fatty Acids
9
Q
constituents of phospholipids or triglycerides
A
Fatty Acids
10
Q
derived from the hydrolysis of triglycerides in the adipose tissue
A
Fatty Acids
11
Q
substance for the conversion of glucose for gluconeogenesis
A
Fatty Acids
12
Q
Fatty acids bound to albumin are ____
A
unesterified
13
Q
Fatty acids constituent of triglycerides or phospholipids __
A
esterified
14
Q
short fatty acids chain number:
A
4-6
15
Q
medium fatty acids chain:
A
8-12
16
Q
long chain of fatty acids:
A
> 12
17
Q
fatty acids with no double bonds
A
saturated
18
Q
fatty acids with one double bond
A
monosaturated
19
Q
fatty acids with greater than or equal to double bond
A
polyunsaturated
20
Q
Classification of fatty acids: butyric acid
A
saturated
21
Q
Classification of fatty acids: oleic acid
A
monosaturated
22
Q
Classification of fatty acids: linoleic acid
A
polyunsaturated
23
Q
Classification of fatty acids: glycerol
A
saturated
24
Q
Also known as neutral fat
A
triglyceride
25
triglyceride contains ----- fatty acids attached to one molecule of glycerol
three fatty acids
26
Contains saturated fatty acids or unsaturated fatty acids; veryhydrophobic
triglycerides
27
No charged groups, water insoluble, neutral lipid
triglyceride
28
Main storage of lipid in man
triglycerides
29
triglycerides are mainly found in
adipose tissues
30
triglycerides percentage of stored fat in body
95%
31
Predominant form of triglyceride in plasma
glyceryl ester
32
Provides insulation
Lipid - Triglycerides
33
Enzyme for breaking down lipids
Lipoprotein Lipase (LPL)
34
hormone for lipid breakdown
epinephrine and cortisol
35
Also known as conjugated lipids
phospholipids
36
Phospholipids contains
two fatty acids attached to one molecule of glycerol
37
phospholipid head group location
third position (phosphorylated end)
38
Hydrophilic end of phospholipid location
outer part
39
Hydrophobic end of phospholipid location
Inner
40
Most abundant lipid in the body
phospholipids
41
Phospholipids are derived from
phosphatidic acid
42
Origin of phospholipids
liver and intestines
43
Not part of the lipid profile; not routinely measured
phospholipids
44
Phospholipids are only measured in
Fetal Lung Maturity
45
Fetal lung maturity collection
amniotic fluid and phospholipids
46
Surfactants of phospholipids
Sphingomyelin and lecithin ratio
47
Three forms of phospholipids: Major form of phospholipids (70%)
Lecithin or Phosphatidyl Choline
48
Three forms of phospholipids: constitutes about 20%
Sphingomyelin
49
Three forms of phospholipids: Constitutes about 10%
Cephalin
50
Also known as 3-hydroxy-5, 6 Cholestene
Cholesterol
51
Unsaturated steroid alcohol contains four rings, component of steroids
Cholesterol
52
amphiphatic lipids
Cholesterol and Phospholipids
53
Important constituent in the assembly of cell membrane
and bile acid (as precursor)
Cholesterol
54
contributes to the metabolism or digestion
of fats in the intestine
Bile acid
55
Lipid that does not serve as fuel of energy of the cells
Cholesterol
56
Unesterified cholesterol: amphiphatic; 30% of the total cholesterol in the body; Present in the plasma or serum, and RBCs; Polar type
Free cholesterol
57
Esterified cholesterol: neutral lipid; 70% of the total cholesterol in the body; also present in plasma or serum; hydrophobic form
Cholesterol ester
58
Important enzyme for esterified cholesterol
LCAT: Lecithin-Cholesterol Acyl Transferase
59
catalyzes the esterification of cholesterol by promoting the transfer of fatty acids from lecithin to cholesterol
LCAT: Lecithin-Cholesterol Acyl Transferase
60
activator for LCAT
APO A-I
61
Promotes fat absorption in the intestine
bile salts
62
cholesterol converted to steroid hormones:
glucocorticoids, mineralocorticoid; estrogen
63
Cholesterol converted to vitamin (absorption of calcium)
Vitamin D
64
Lipid profile test involves:
TAG,Lipoproteins (HD:, LDL, VLDL), Total cholesterol
65
Directly measured with reagent in Lipid profile test
TAG (triglycerides); cholesterol
66
Directly measured with reagent and machine in lipid profile test
HDL
67
Not directly measured with reagent, these are calculated/computed in Lipid Profile
LDL and VLDL
68
essential or important in the diagnosis of lipoprotein diseases and management of lipoprotein disorders and lipid abnormalities
Cholesterol
69
Components of Lipoprotein structure
both lipids and proteins (apolipoproteins)
70
Composition of Lipoprotein structure on the surface (hydrophilic)
Free cholesterol, phospholipids
71
Composition of Lipoprotein structure found in the core regions (hydrophobic)
Triglycerides and cholesteryl esters
72
Characteristics Functions of Apolipoproteins
Highly stable
Ligands for cell receptor
activators and inhibitors of enzymes
amphipathic
73
Apolipoprotein: Apo A-I and A-II
Major LPP location
HDL
74
Function: LCAT activator, ABCA1, lipid acceptor
Apolipoprotein:
APO A-I
75
Function: Inactivates LCAT ; Apolipoprotein:
Apo A-II
76
Apolipoprotein: Apo B-100 ; Major LPP location
LDL, VLDL
77
Apolipoprotein: Apo B-48 ; Major LPP location
Chylos
78
Apolipoprotein: Apo- IV, C-I, C-II, C-III ; Major LPP location
Chylos, VLDL, HDL
79
Apolipoprotein: Apo E ; Major LPP location
VLDL, HDL
80
Apolipoprotein: Apo(a) ; Major LPP location
Lp(a)
81
Function: LDL receptor ligand ; Apolipoprotein:
Apo B-100, Apo E
82
Function: remnant receptor ligand ; Apolipoprotein:
Apo B-48
83
Function: LPL cofactor ; Apolipoprotein:
Apo C-II
84
Function: LPL inhibitor ; Apolipoprotein:
Apo C-III
85
Function: Plasminogen inhibitor ; Apolipoprotein:
Apo(a)
86
Major types of lipoproteins
Chylomicrons, VLDL, LDL, HDL
87
Heaviest lipoprotein
HDL
88
Major protein of chylomicrons
Apo B-48
89
Major protein of VLDL and LDL
Apo B-100
90
Major protein of HDL
Apo A-I
91
Total lipid (% by weight) 98%
Chylomicrons
92
Total lipid (% by weight) 89-96
VLDL
93
Total lipid (% by weight) 77%
LDL
94
Total lipid (% by weight) 50%
HDL
95
Triglyceride (% by weight) 84%
Chylomicrons
96
Triglyceride (% by weight) 44-60%
VLDL
97
Triglyceride (% by weight) 11%
LDL
98
Triglyceride (% by weight) 3%
HDL
99
Largest and least dense lipoprotein
chylomicrons
100
Major transporter of exogenous triglycerides
chylomicrons
101
Chylomicrons are produced in
intestines
102
Exogenous triglyceride transports
dietary lipids to hepatic and peripheral cells
103
Chylomicrons are completely cleared from plasma or circulation within
6-9 hours post-prandial
104
Fasting required for lipid profile testing
12 hours
105
Chylos present in blood causes ---- in lipid profile
false increased
106
Lipid profile is done to determine
normal metabolism
107
Lipid and Glucose Tests fasting hours:
10 hours
108
Also known as pre-beta lipoprotein
very low density lipoproteins
109
Electrophoresis location of VLDL
pre-beta region
110
VLDL is produced in
liver and intestines
111
Endogenous pathway:
Transfer triglycerides from the liver to peripheral tissues
112
Also known as beta lipoprotein or bad cholesterol
Low density lipoprotein
113
Electrophoresis location of LDL
beta region
114
Most cholesterol rich; most atherogenic lipoprotein
LDL
115
atherogenic: contribute to the formation of Insoluble fatty
plaque of blood flow (obstruction in blood vessel)
LDL
116
Formed from lipolysis of VLDL to IDL (intermediate density lipoprotein
LDL
117
LDL pathway
Exogenous (dietary chole to peripheral)
118
Also known as: Alpha lipoprotein or good cholesterol
High density lipoprotein
119
Electrophoresis location of HDL
Alpha region
120
HDL is produced in the
liver and intestines
121
HDL pathway
reverse cholesterol transport mechanism
122
HDL transfers excess cholesterol back to ---
Liver
123
High HDL relationship to coronary heart disease
lower risk for CHD
124
High LDL relationship to coronary heart disease
increases the risk for CHD
125
CARDIOPROTECTIVE LIPOPROTEIN
HDL
126
Only minor type of lipoprotein; LDL lipoprotein like particle
Lipoprotein(a)
127
has a variable migration when subjected to electrophoresis; pre-beta region or between LDL and Albumin region
Lipoprotein(a)
128
Confers increased risk for: premature coronary heart disease and stroke
Lipoprotein(a)
129
Lipoprotein (a) competes with plasminogen for
fibrin
130
Important for fibrinolysis
plasminogen
131
Also known as the SINKING PRE-β LIPOPROTEIN
Lipoprotein(a)
132
density of lipoprotein(a) is the same as
LDL
133
Product of VLDL catabolism
INTERMEDIATE DENSITY LIPOPROTEIN (IDL)
134
IDL migration to electrophoresis
pre-B or Beta region
135
Abnormal lipoprotein: found in obstructive jaundice
and LCAT deficiency
Lipoprotein X (Lpp X)
136
Lipoprotein X (Lpp X) is specific and sensitive indicator for
cholestasis
137
lipid content is mostly phospholipid and free cholesterol (90%)
Lipoprotein X (Lpp X)
138
Lipoprotein X contains
Apo C and albumin
139
Abnormal lipoprotein: known as “abnormally migrating β-VLDL”
B-VLDL
140
also known as floating beta lipoprotein
B-VLDL
141
has the density of VLDL by ultracentrifugation but
migrates with LDL in the β region during electrophoresis
B-VLDL
142
B-VLDL is found in what disease
type 3 hyperlipoproteinemia or dysbetalipoproteinemia
143
Rich in cholesterol content than VLDL
B-VLDL
144
Adult reference range for lipids: Total cholesterol
140-200 mg/dl
145
Adult reference range for lipids: HDL cholesterol
40-75 mg/dL
146
Adult reference range for lipids: LDL cholesterol
50-130 mg/dL
147
Adult reference range for lipids: triglyceride
60-150 mg/dL
148
Conversion factor for total cholesterol
0.026 mmol/L
149
Conversion factor for triglyceride
0.011 mmol/L
150
Conversion of dietary lipids into more polar (amphipathic) compounds by Pancreatic Lipase
Lipid absorption
151
can also be linked to infection, no absorption, problem in lipid absorption (too much fat globules in feces)
Steatorrhea
152
Lipid absorption: conversion of triglyceride
monoglycerides
153
Lipid absorption: conversion of cholesterol esters
free cholesterol
154
Lipid absorption: conversion of phospholipids
lysophospholipids
155
Pathway: Chylomicrons: synthesized in the intestine, carrying dietary lipids to the circulation
Exogenous pathway
156
Pathway: Triglycerides in the liver: packaged into VLDL, carrying lipids to the circulation
Endogenous pathway
157
Pathway: Chylomicrons → chylomicron remnant particles
Exogenous pathway
158
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
Endogenous pathway
159
Pathway: HDL remove excess cholesterol transport pathway deliver cholesterol back to the liver o To recycle unused and excess cholesterol
reverse cholesterol transport mechanism
160
Lipid disorders: Deposition of esterified cholesterol in artery wall
Arteriosclerosis
161
Lipid disorder: Increased smooth muscle cells, extracellular lipid, calcification, fibrous tissue, macrophages, lymphocytes, fibrin clots, and platelets (plaque)
Arteriosclerosis
162
Coronary Artery disease affects
heart (angina and MI)
163
Peripheral vascular disease (PVD) affects:
arteries in the arms or legs
164
Cerebrovascular disease (CVD) affects
vessels of the brain (stroke)
165
Increased cholesterol
Increased LDL, Decreased receptors
Amphipathic, Clear appearance but with high level
Hypercholesterolemia
166
Increased Triglycerides; Decreased LPL or Apo C-II VLDL -/→ VLDL remnants; Chylos -/→ Chylos remnants; Highly hydrophobic
Hypertriglyceridemia
167
Increased Triglycerides, Cholestero; Increased VLDL and Chylos remnants; Presence of Apo E2/2
Combined Hyperlipoproteinemia
168
Other Lipid Disorder: Also known as Type 2-a
Familial Hypercholesterolemia
169
Other Lipid Disorder: Also known as Type 3 Hyperlipoproteinemia
Familial Dysbetalipoproteinemia
170
Other lipid disorder: Basses-Kornzweig Syndrome
Abetalipoproteinemia
171
Other lipid disorder: Lipid Storage Disease
Niemann-Pick disease
172
Lipid measurement principle for cholesterol measurement
Dehydration and Oxidation of cholesterol to form a colored compound
173
Preparation for cholesterol measurement:
2 weeks usual diet; fasting is not strictly implemented
174
Hemolyzed serum causes __ in cholesterol
false increased
175
Water contamination effect in cholesterol
less accurate
176
Color developer for cholesterol measurement
Glacial Acetic acid, acetic anhydride, conc. sulfuric acid
177
Lipid measurement triglyceride requirement
12 hours fasting
178
Lipoprotein Measurement tube for research studies
EDTA (plasma)
179
Non enzymatic method for cholesterol measurement
Abell Kendall
180
Abell Kendall: Cholesteryl esters: hydrolyzed with
Alcoholic KOH
181
Abell Kendall: Unesterified cholesterol: extracted with
Hexane
182
Non enzymatic method for cholesterol is measured with
Liebermann - Buchard reaction
Salowski Reaction
183
Liebermann - Buchard reaction: Cholesterol + sulfuric acid + acetic anhydride -> produces:
Green solution (Cholestadienyl Monosulfonic Acid)
184
Salowski reaction for cholesterol produces
Red solution (Cholestadienyl Disulfonic Acid)
185
Involves colorimetry - mix, incubate, and measure for Abell Kendall (Non-enzymatic)
1-step method
186
involves colorimetry and extraction for Abell Kendall
2- step method
187
3 step method for Abell Kendall
Colorimetry, Extraction, Saponification
188
4 step method for Abell Kendall
Colorimetry, Extraction, Saponification, and precipitation
189
Enzymatic Method for Cholesterol measurement uses
Cholesterol oxidase
190
CDC reference method for cholesterol measurement
Abell, Levy and Brodie Method
191
1st enzyme for enzymatic method (cholesterol)
Cholesteryl esterase
192
2nd enzyme for enzymatic method (cholesterol)
Cholesterol oxidase
193
Enzymatic method 3rd enzyme for cholesterol
Peroxidase
194
Color produced in cholesterol oxidase method
quinoneimine dye
195
TRIGLYCERIDE MEASUREMENT: non-enzymatic method measures
glycerol
196
Product of Glycerol + Periodic acid (triglyceride measurement)
Formaldehyde
197
Colorimetric measurement for triglyceride
Van Handel and Zilversmith
198
Van handel and Zilversmith: Formaldehyde + Chromotropic acid product
Blue solution
199
Principle of Hantzch Condensation
Fluometric
200
Hantzch Condensation: Formaldehyde + Diacetyl acetone + NH3 → produces ___
Yellow solution
201
Enzymatic Method for triglyceride
Glycerol kinase
202
Product of glycerol + ATP -- glycerokinase-->
Glycerophosphate + ADP
203
Pyruvate kinase for triglyceride: ADP + PEP (phosphoenolpyruvate) –Pyruvate kinase → product
ATP + Pyruvate
204
Triglyceride measurement: Pyruvate + NADH + H+ - LD → product
Lactate + NAD (measured at 340 nm)
205
Triglyceride measurement: Glycerol-Phosphate Oxidase measures
color of end product
206
CDC reference method for Triglyceride
Modified Van Handel and Zilversmith
207
Lipoprotein measurement general methods:
Ultracentrifugation and Electrophoresis
208
Reference method for the quantitation of lipoproteins
Ultracentrifugation
209
Lipoprotein measurement: Ultracentrifugation of plasma is done for
24 hours
210
Lipoprotein measurement by ultracentrifugation is measured by
molecular density
211
Principle of ultracentrifugation: The density of the lipoprotein is compared with the density of the
Potassium bromide
212
Density of potassium bromide
1.063
213
Order from lightest to heaviest lipoprotein in ultracentrifugation
Chylomicrons
VLDL
LDL
HDL
214
Lipid stains for Electrophoresis of lipoproteins
Oil red O, Fat Red 7B and Sudan
black
215
Electrophoresis: 4 bands with fat stains: fastest
alpha lipoprotein (HDL)
216
Electrophoresis: 4 bands with fat stains: Pre-beta
VLDL, LP(a)
217
Electrophoresis: 4 bands with fat stains: Beta
LDL
218
Electrophoresis: 4 bands with fat stains: stationary at origin
chylomicrons
219
Most sensitive supporting medium for lipoprotein electrophoresis:
agarose gel
220
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
Polyanion precipitation
221
HDL is quantified in the supernate by:
Abell kendall (total cholesterol assay)
222
Low-Density Lipoprotein (LDL) Methods: Friedwald formula for VLDL mg/dL
VLDL= Triglyceride / 5 = mg/dL
223
Low-Density Lipoprotein (LDL) Methods: Friedwald formula for VLDL mmol/L
VLDL= Triglyceride / 2.175 = mmol/L
224
Ultracentrifugation of serum at native density gradient of ____ to float VLDL
1.006 g
225
LDL formula
Total cholesterol - (HDL + VLDL)
226
Apolipoprotein methods for testing
✓ Immunonephelometry
✓ Immunoturbidimetric Assay
✓ Immunochemical Method
227
apolipoprotein for determination of LDL and VLDL conc.
Apo B
228
Apolipoprotein for determination of HDL conc.
Apo A-I
229
Positive risk factor age for men (CHD)
> or = to 45
230
Positive risk factor age for women (CHD)
> or = to 55 (premature menopause)
231
Hypertension BP measurement
BP > or = to 140/90 mmHg
232
Lipoprotein effect to CHD: HIGH LDL; LOW HDL
Increased risk
233
LDL cholesterol concentration: > or = 160mg/dL
= or <1 RF
234
LDL cholesterol concentration: > or = 130mg/dL
= or >2RF
235
LDL cholesterol concentration: >= 100 mg/dL
with CHD or equivalent
236
Diabetes mellitus = CHD risk equivalent due to
active lipolysis that is not converted to glucose
237
Negative risk factor for CHD: HDL cholesterol concentration
> or = to 60mg/dL
238
Negative risk factor for CHD: LDL cholesterol concentration
<100mg/dL: LOW
239
Healthy fats to prevent CHD
Omega-3 or Omega- 6
