Hyperlipidemia (Exam 1)

Question 1

Cholesterol

Answer 1

-In all cell membranes and is essentail part of phospholipid bilayer

-Important building block for: Estrogen and test, Vit D, Cortisol, and Bile acids

-Highly insoluble and is in our skin. It has to be transported into cells by binding with receptors

Question 2

Cholesterol Make-up

Answer 2

-Exogenous 25% (Comes from out diet) Has some effect on the cholesterol level but it is not that concerning

-Endogenous 75% (Comes from what our body makes) (Liver)

Question 3

What pathway produces endogenous cholesterol?

Answer 3

Hydroxymethylglutaryl coenxyme A reductase

(HMG-CoA Reductase)

-Uses SATURATED fat

Question 4

LDL

Answer 4

Liver has LDL receptors on it in which LDL from the blood attaches to.

HMG CoA reductase turns LDL into cholesterol.

If you have excessive cholesterol the pathway is blocked. The liver recognizes it is not producing cholesterol and think it needs more LDL receptors

Negative feedback loop

Question 5

6 different kinds of lipoproteins

Answer 5

-Combination of lipids (Cholesterol, trigylcerides) and proteins.

Question 6

HDL-C (Good)

Answer 6

50% Protein

20% cholesterol

5% triglycerides

Question 7

LDL-C (Bad)

Answer 7

-20-25% protein

-45-55% cholesterol

-5-10% triglycerides

Because they are made up of less protein and higher level of cholesterol

Increase risk for atherosclerosis

Question 8

VLDL

Answer 8

-55-65% triglycerides

-Cant measure these.

-Increase risk of heart disease

Question 9

Hypercholesterolemia

Answer 9

-Too much cholesterol

-Hyperlipemia (HL) (Most common term)

-Dyslipdiemia

Question 10

How do we test for Hyperlididemia?

Answer 10

Draw blood to look for HDL and LDL cholesterol. Someone with high lipids will have a pink tent serum

Question 11

Hypercholesterolemia: Check

Answer 11

-Check while fasting overnight

-High level of cholesterol also doesnt have symptoms

Question 12

Total Cholesterol Score

Answer 12

HDL + LDL + Trigcerides/5

Question 13

Hypercholesterolemia: Cholesterol levels (Do not memorize)

Answer 13

Range 100-200

HDL: Female > 55 mg/dl. Male > 45 mg/dL

LDL: <130 mg/dL

Triglycerides: <160 mg/dL. Range 40-160

Question 14

Familial Hypercholesterolemia

Answer 14

-One way people develop high cholesterol and it genetically linked.

-Defect in LDL receptors in the liver cells. Liver cannot remove LDL from blood stream so LDL remains elevated in the blood

-It is hard to treat and reduced no matter the intervention because we are up against genetics and things we cannot change

Question 15

When do we look for familial pattern of having high cholesterol?

Answer 15

When young adults and children present with hypercholesterolemia

Question 16

Hypercholestrolemia: General Risks

Answer 16

-Age
-Fam History
-Tobacco use
-HTN
-DM
-Poor diet
-Inactive

Question 17

Atherosclerosis

Answer 17

-Elevated LDL and Cholesterol (Increase risk)

-It is a build of cholerstol in vessels.

Question 18

Arteriosclerosis

Answer 18

A form of atherosclerosis where our arterial wall starts to thicken and harden.

Question 19

Formation of atherosclerotic plaque

Answer 19

-Starts with an injury to the endothelium. (Inside layer of our vessels)

-Coronary and Peripheral arterial walls.

-Cigarette smoking injures endothelium in our vessels.

-Chronic HTN can cause injury

-Hyperglycemia can also cause damage

Question 20

Atherosclerosis: Steps

Answer 20

First we see INJURY and after the injury we see INCREASED PERMEABILITY.

When that happens molecules more easily get through the endothelial layer.

LDL molecules get into and under the wall which cause an inflammatory process to occur.

Macrophages arrive to engulf lipids which produce FOAM cells.

These FOAM cells appear as fatty streaks in the vessel walls and this LEADS to the development of plaque

Question 21

Controlling Cholesterol levels in trying to prevent what from occuring

Answer 21

Atherosclerosis (which narrows the vessel)

Question 22

The release of inflammatory mediators encourage excess lipids and debris to accumulate in the vessel wall creating….

Answer 22

a lipid core

plaque with large lipid core prone to rupture. This can block the vessel off entirely

Question 23

Atherosclerosis: How do we look for it?

Answer 23

-C-reactive protein (CRP)

-Marker of systemic inflammation

-Drawn from blood and we can tell if there is increase inflammation in the body. (Just because it is elevated does not meant there is atherosclerosis)

Question 24

Atherosclerosis: Why is it risky?

Answer 24

The ruptured plague can lead to platelet aggregation which can cause a thrombus formation

Question 25

What plaques are more stable?

Answer 25

Older plaques are more stable because they have collegen

Question 26

Effects of atherosclerosis on the heart

Answer 26

-Myocardial infraction

Question 27

Coronary Heart Disease

Answer 27

-Atherosclerosis and the formation of plaque in the artery walls.

-Insufficient delivery of O2 to the heart. (Ischemic heart Disease)

-Atherosclerotic Cardiovascular Disease (ASCVD)

Question 28

How do we lower the risk of atherosclerosis?

Answer 28

Decrease our LDL

Increase our HDL

Treat with medication

Improve diet

Exercise

STOP SMOKING

Question 29

Risk factors we can help clients change

Answer 29

-Diet
-Weight control
-Regular Exercise
-Avoid tobacco