Fat Stuff

Question 1

• Step that produces NADPH?
• • ACC? (2) - ? (3)
• FAS first product? Uses?
• RDS fo biosynthesis? RDS of Oxidation?
• HSL - P active when?
• KA due to? (2) DKA due to?
• Cholesterol synthesis uses?
• Regulation of Cholesterol synthesis? (3)
• Oleic acid is? Dietary chol?
• Most important diet factor?
• Gold standard diet?
• Rank fats?

Answer 1

• Malate to pyruvate
• Citrate, insulin; Glucagon, AMPK, Long chain FAcyl coA
• Acetyl CoA; NADPH
• ACC; HSL
• Epi
• Starvation, Low carb diet; No insulin so HSL is active
• NADPH
• SREBP, degradation, phosph of enzyme
• Essential; does not equal serum LDL
• Adherence
• Low fat, low calorie
• Sat (7%) > Trans fats > n-6 fats > cholesteorol (300mg) > Mono/fish

Question 2

• Plasma FA’s on?
• Linoleic acid? Linolenic?
• ACC transcription increases with?
• VLDL made of? (2)
• 3 effects of alcohol?
• What rxn is irreversible?
• Glycerol can enter what?
• Inihibits CAT1?
• B12 and biotin (mutase) for what rxn?
• Very long Chain FA’s broken down where?

Answer 2

• Albumin
• Arach precurosor; Growth/development
• Calories
• FFA’s and Glycerol 3-p (via glycolysis)
  1. ) Ethanol –> Acetate –> Acetyl CoA –> FA Synthesis
  2. ) High NADH = Glycerol 3-p synthesis 3.) 1 + 2 = VLDL
• Pyruvate to acetyl CoA
• gycolysis or gluconeogenesis
• Malonyl CoA
• Proprionyl CoA –> Suc CoA
• Peroxisome

Question 3

• B oxidation enzymes deficiency called?
• Muscle cramping can be due to?
• Peroxismal X linked enzyme defic?
• alpha hydroxylase defic called? Effects?
• Chylomicron markers? VLDL? Remnant? LDL? HDL?
• C2 removal of TG’s via?
• Remnant liver receptor? LDL?
• ApoA?
• Storage lipid? Membrane: 2 phospho? 1 glyco?
• PG steps? (4)

Answer 3

• Sudden infant death
• Carnitine defic.
• Zellweger
• Refsum; Neurologic
• B48, C2, E; B100, C2, E; B48, E; B100, E; A1
• LPL lipase
• E; B100
• Increased atherosclerosis
• TAG; glycero (OH); Sphingo (choline), Sphingo
• Phospholipid –> Phospholipase A2 –> Arach –> 5 - Lipooxygenase (LT) and COX (PG’s)

Question 4

• Dyslipidemia:
• 4 groups to treat?
• LDL = ?
• 7 risk factors
  1. ) FH: AD defect in? 3 signs?
  2. ) F. Dysbetalipo.: AR defect in? Leads to? Signs?
  3. ) Hypertrig: Genetics? Normal value? Signs? (2) Severe? Clearance?
  4. : HDL: ABCA1 mutation? apo(a) increases risk of?

Answer 4

• ASCVD, DM, LDL>190, 7.5% risk
• LDL = Total - (HDL + TG/5)
• Age, Male, Smoke, BP > 140, High total C, low HDL, DM
• LDLR, Arcus Cornealis, Xanthelasmas, Tend. X
• ApoE2; Remanant accum., Planar xanth
• SNPS,

Question 5

Dyslipidemia:

• 2 High intensity statins?
• MOA? (5)
• 6% rule? 4 SE’s?
• Cole/chol drugs called? MOA?
• Sterol Esters do what?
• Ezetimir: Works where?
• LDL > 200: Mipomersen MOA? Liposorber MOA?
• TG: 1.) High end statins? 2.) Fibrates MOA? SE? (3) 3.) Omega 3’s work for? 4.) Niacin MOA? SE? (3)

Answer 5

• Ator, ros
• Inh. HMG Co Reductase, Increase HDLR, Lower HDL, Incr. Catab, Decrease hepatic pool of free chol
• double dose lowers by 6%; Myo, cog, T2DM, Liver enz
• BAS resins, inhibit bile reabsorption
• Inhibit chol. absorb
• Brush border
• Target ApoB of VLDL; Apheresis
  1. ) Yes 2.) PPAR a agonists to increase FA ox.; Renal, skin rash, myopathy 3.) Very high TG’s 4.) Lower VLDL/TG synthesis, incease Fat Ox., Skin rash, gout, IBD