Hyperlipidemia and atherosclerosis Flashcards

1
Q

“وقالوا الحمدلله الذي هدانا لهذا وما كنا لنهتدي لولا أن هدانا الله لقد جاءت رسل ربنا بالحق ونودوا أن تلكم الجنة أورثتموها بما كنتم تعملون”
بسم الله الرحمن الرحيم

Hyperlipidemia mean ?

A

it is raised or abnormal level of Lipids or lipoproteins in the blood related to CVS diseases
divided into
1ry hyperliporoteinemia
2ry hyper ;;;;;;

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2
Q

Primary hyperlipidemia

origin types and how it can be assessed ?

A

It is single gene or polygenic affection
5 types most common 2a 2b 4
They are diagnosed by alterations of the TAG and Cholesterol Concentration after 10-12 of fasting !

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3
Q

decrease in lipoprotein lipase leads to ? and is there any other factor ?

A

Hyperlipoproteinemia type 1

the Precursor of LL is apolipoprotein CII

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4
Q

discuss the relation between chylomicrons and hyperlipoproteniemia type 1

A

there is excessive chylomicronemia > 1000mg/dl

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5
Q

the inflammation compantion to the Hyperlipoproteniemia 1?

A

The acute pancreatitis leading to acute abdomen

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6
Q

what about TAG In fasting in hyperlipoprotenemia ?

A

There is high fasting triacelyglycerolemia

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7
Q

what appear on taking blood sample of hyperlipoprotemia 1 patient ?

A

The plasma appear creamy white

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8
Q

what is the relaiton between coronary diesases and the hyperlipoproteniima 1?

A

there is no increase in cholesterol and no high risk of coronary heat disease

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9
Q

The most common form of hyperlipoproteniemia is ?

A

type 2

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10
Q

hyperlipoproteniema type 2

A

most common divided into 2a 2b

and it may be familial polygenic or sporadic as well as diatry factors

depends on TAG elevation and LDL cholesterol

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11
Q

hyperlipoproteniemia type 2 depends on ?>

A

TAG elevation and LDL cholesterol

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12
Q

The origin of hyperlipoproteinemia type 2 a

familial hypercholestrolemia ?

A

due to mutation in the gene expressing the LDL receptor or APO B gene
resulting in elevated plasma cholesterol level due to increased LDL-Cholesterol

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13
Q

risks of hyperlipoproteniemia 2a type mention them ,

risks of familial hypercholestrolemia

A

Premature atherosclerosis
and Ischemic Heart diseases
Hand and ankle (Tendon Xanthomas )

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14
Q

(Tendon Xanthomas ) appear in ?

A

Hyperlipoproteinemia type 2 in hands and ankles

Familial hypercholetsrolemia

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15
Q

classify LDL receptor mutations in hyperrlipoproteniemia type 2 ,a

A

1-NO receptors
2-no binding with LDL
3-Not internalized in calrinitine coated pit
4-no releases of LDL if internalized and cannot be recycled

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16
Q

hyperlipoproteinemia type 2b

secondary combined hyperlipidemia :

A

increased TAG and cholesterol due to less binding of LDL to its receptor

 increased LDL and IDL 
over production :
increase in TAG 
INCREASE IN Acetyl CoA
increase in   B-100 synthesis 
Metabolic syndrome occur
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17
Q

Metabolic syndrome

mean ?

A
a group of risk factors increasing the risk for 
Heart disease
Diabetes 
Stroke 
وقد حدث !
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18
Q

فكيف إذا جئنا من كل أمة بشهيد وجئنا بك علي هؤلاء شهيدا يومئذ يود الذين كفروا وعصوا الرسول لو تسوي بهم الأرض ولا يكتمون الله حديثا …!!!!!!!
Risk Factors for Metabolic syndrome mention

A

You may have 1 but there should be 3 at least to be diagnosed as Metabolic syndrome :

Abdominal obesity apple shape
Low HDL 
High TAG
High blood pressure 
High fasting blood sugar DM II , insulin resistance
19
Q

type 3 hypelipoproteniemia known as ?

A

Broad beta disease
dysbetalipoproteinemia
remainant hyperlipidemia

20
Q

Dysbetalipoproteniemia casuses?

A

this is due to mutation in APO E genotype

Causing no binding of chylomicrons and IDL and their accumulation in plasma so increased cholesterol and TAG in plasma

21
Q

hyperlipoproteniemia type IV Explain !

A

This is hypertriglycreidemia this is due to
Obesity INCREASD FAT AND CHO INTAKE > INCREASEING VLDL SYNTHESIS
DM II

HIGH TAG HIGH HIGH HIGH

22
Q

Hyperlipoproteinemia type V explain

A

Similart to type 1 , and this is due to increased VLDL and Chylomicrons

associated with glucose intolerance thus Decreasing work of lipoprotein lipase and

increasing TAG

INCREASING VLDL INCREASING LDL

23
Q

ولو أنهم فعلوا ما يوعظون به لكان خيرا لهم وأشد تثبيتا وإذا لآتيناهم من لدنا أجرا عظيما ولهديناهم صراطا مستقيما !

Familial liporotein a casue ? why?

A

risk for Premature coronary heart disease

due to ( atherosclerosis + thrombosis )

thrombosis due to inhibition of fibrinolysis !

24
Q

Tangier diseases explain :

A

This is due to rare genetic diseases due to problems in HDL and apo A-1

HDL apo A-1 responsible for prevention of cholesterol ester depostition in organs

so the depositon leads to ?

Oragne tonsils
Heaptosplenomegaly
CAD coronary arterty disease

25
Q

Oragne tonsils
Heaptosplenomegaly
CAD coronary arterty disease
they occur in ?

A

Tangier disease TD

26
Q

RISKS FOR secondary hyperlipoproteinemia :

A

KODH

Obesity
obstructive jaundice
DM
Hypothyroidism ! !! ! !! !@!! !
Kidney disease like nephrotic syndrome
27
Q

Biochemical basis of Atherosclerosis

A

Hyperch

28
Q

decreased HDL/LDL below 0.3 is a risk for atherosclerosis

why women are less risk than men ?>

A

Due to estrogen effect on the apoliporotein genes in liver
increasing Estrogen
decreases VLDL AND LDL
INCREASISNG HDL
less risk for atherosclerosis and coronary disease

29
Q

associated with HDL and one of the most predictive values in patients with cardiac diseases :

A

Apo A1 ITS deficiency may lead to atherosclerosis

30
Q

يا عمر لا يصدنك الشيطان عن آيات الله بعد إذ أوتيتها ووعيتها

PUFA and atherosclerosis relation ?>

A

Decreases the risk of atherosclerosis this is because

Poly unsaturated fatty acids increase solubility of cholesterol and their excretion through portal circulation

31
Q

sugars and atherosclerosis discuss relationship !

A

Sucrose and fructose are ( atherogenic ) as they increase synthesis of TAG !

32
Q

cigarate drinking and coffe and atherosclerosis ! what is the relation

A

The Caffine …. inhibits phosphodiestrases so activate HSL

Nicotine increases catecholamines>adenylyl cyclase > stimulates HSL

HSL stimulation activate lipolysis and increasing FAs and so plasams lipoproteins cholesterol

cigaratte Nicotine increases oxidants and the oxidation of the LDL and casuing arterial wall damage
smoking compormis the antioxidant vitamis especially Vitamin C
بيعلب في نظام الاكسدة في الجسم ! هو بينتج عوامل مؤكسدة وبيضرب مضادات الأكسدة

33
Q

Caffine and atherosclerosis !

A

The Caffine قولك لأمك طيب …. inhibits phosphodiestrases so activate HSL
HSL stimulation activate lipolysis and increasing FAs and so plasams lipoproteins cholesterol

34
Q

Nicotine and atherosclerosis discuss

A

Nicotine increases catecholamines>adenylyl cyclase > stimulates HSL

cigaratte Nicotine increases oxidants and the oxidation of the LDL and casuing arterial wall damage

smoking compormis the antioxidant vitamnis especially Vitamin C
بيعلب في نظام الاكسدة في الجسم ! هو بينتج عوامل مؤكسدة وبيضرب مضادات الأكسدة

35
Q

HTN and atherosclerosis discuss

A

Increasing BP more than 140/90> wall damage > entery of lipoproteins into the wall

36
Q

Stress and Atherosclerosis ?>

A

Increasing catecholamines increasing adenylyl cyclase and HSL and FAs and lipoprotein synthesis

37
Q

Family hisoty of CHD and atherosclerosis ?

A

BECAUSE ANY FAMILIAL DISEASES

DM OR Familial Hypercholestrolemia increasing risk for Atherosclerosis

38
Q

MAN >45
WOMEN >55
are more liable to atherosclerosis

A

becasue women has Estrogen

39
Q

Alcohol drinking and atherosclerosis discuss

A

alcohol is oxidized into acetaldehyde this leads to increased NADPH/NAD reation
increasing converrsion of DHP into glycerol 3 phosphate and glycerol ok ::K:

40
Q

Biochemical basis in prevention of atherosclerosis

? .

A

Dietary
life style
terapy drugs

41
Q

The diet change in atheroscleosis “?

A

Decreasing sweets and refined CHO
Decreasing Saturated fats and ANIMAL FAT
increasing Unsaturated and PUFA
iNCRASING ANTIOXIDANTS vITAMINS A C E
INCREASING PLANT STEROLS
INCREASING SOLUBLE FIBERS

42
Q

Theraputic lifestyle change in atherosclerosis : ?»

A

Stop smoking
STOP STRESS !!!
Weight reduction
physcial exercise

43
Q

Drug therapy of hyperlipdemia in atherosclerosis ? =

A

Statins HMG CoA reductase enzyme

44
Q

” قل إنني هداني ربي إلي صراط مستقيم دينا قيما ملة إبراهيم حنيفا وما كان من المشركين “

A