Clinical Laboratory Studies

Question 1

Risk Factors for CHD

Answer 1

• Age
• Family history
• Gender-specific male
• Uncontrolled HTN
• Elevated total cholesterol
• Uncontrolled DM
• Smoking/componentes of cigarette smoke
• Physical Inactivity
• Obesity/overweight
• Post menopausal
• Pro-inflammatory state: high levels of C-reactive protein
• Uncontrolled stress
• Poor diet
• Alcohol use

Question 2

Cholesterol

Answer 2

a waxy, fat-like substance found in all cells of the body. It is an essential component of cell walls/cell fluidity and is a precursor molecule for VitD and steroid hormones.

Question 3

How is cholesterol transported in the blood?

Answer 3

with a carrier molecule (a lipoprotein)

LDL, HDL, VLDL

Question 4

What cholesterol is associated with chronic inflammation?
(ex: atherosclerotic plaques)

Answer 4

LDL and VLDL

Question 5

Total Cholesterol

Answer 5

HDL + LDL + triglycerides

Question 6

What components are present on a lipid panel?

Answer 6

• Total cholesterol
• HDL
• LDL
• Triglycerides

Question 7

How are high density lipoproteins (HDL) associated with coronary heart disease risk?

Answer 7

Inversely

Question 8

Your patient has low HDL concentrations on their blood work. What education can you provide to improve HDL value?

Answer 8

participate in regular aerobic exercise

Question 9

Low Density Lipoproteins (LDL) are accepted as a causal risk factor of:

Answer 9

• myocardial infarction
• Atherosclerotic cardiovascular disease

Question 10

How is atherosclerotic plaque formed?

Answer 10

LDLs invade tunica interna blood vessels + form atheroma&raquo_space; WBCs establish low grade inflammation&raquo_space; smooth muscle cells proliferate and enter this area&raquo_space; fibrous connective tissue accumulates&raquo_space; macrophages are attracted to the area&raquo_space; forms a swelling in the artery

Question 11

Plaque formation is

Answer 11

self propagating

Question 12

How are VLDL values calculated?

Answer 12

usually estimated as a % of your trigylceride value

Question 13

Which lipoprotein is an independent risk factor for CAD and also a risk factor for CHD, stroke, thrombosis?

Answer 13

Lipoprotein A

Question 14

When are cholesterol ratios helpful?

Answer 14

When an individual has high HDL

Question 15

How does a cholesterol ratio associate with risk of heart disease?

Answer 15

Lower ratio = lower risk of heart disease

Reccomendation: 5 or less

Question 16

Types of Trigylcerides

Answer 16

• Saturated fats
• Unsaturated fats: Monounsaturated or polyunsaturated; cis- or trans- fatty acids

Question 17

Saturated fats

Answer 17

fat molecules that have NO double bonds (saturated with H)

Question 18

How do saturated fats impact risk of heart disease?

Answer 18

high levels of saturated fats = increased heart disease risk

Question 19

Unsaturated fats

Answer 19

fat molecules in which there are one or more double bonds

Question 20

Monounsaturated fats

Answer 20

one double bond

Question 21

Polyunsaturated fats

Answer 21

multiple DB

Question 22

Cis Fatty Acids

Answer 22

chains of carbon atoms are on the same side of the double bond resulting in a kink

Question 23

Trans-fatty acids

Answer 23

uncommon in nature, commonly produced industrially from vegetable fats.
Increased intake associated with coronary vascular disease

Question 24

How are triglycerides managed?

Answer 24

Medications (statins) and lifestyle

Question 25

Diabetes in a disease of hyperglycemia that creates a proinflammatory state. How does this increase the risk for stroke/ischemic injury?

Answer 25

tumor necrosis factor-a and cytokines cause adipose tissue to release proinflammatory markers causes platelet activation = increased risk for stroke and ischemic injury

Question 26

Structural abnormalities that are characteristic of the diabetic heart.

Answer 26

• Fibrosis
• Cardiac hypertrophy
• Impaired coronary microvascularization perfusion
• Mitochondria perfusion
• Impaired calcium handling