Hyperlipidemia SEM 2

Question 1

Describe cholesterol.

Answer 1

A waxy, fat-like substance produced in the liver and is found in certain foods such as meat and diary.

Question 2

Why does the body need cholesterol?

Answer 2

The cell membranes need it to produce hormones, vitamin D and bile acid. It is also involved in steroid hormone synthesis.

Question 3

How does the cholesterol travel through the blood.

Answer 3

Cholesterol travels through the blood attached to a protein. The combination is called lipoprotein.

Question 4

Name the three types of lipoprotein.

Answer 4

High Density Lipoprotein.
Low Density Lipoprotein.
Very Low Density Lipoprotein.

Question 5

What defines the different types of lipoprotein?

Answer 5

The specific type depends on how much protein there is in relation to fat.

Question 6

List the different types of cholesterol transporters.

Answer 6

Chylomicrons (transport of exogenous cholesterol)
VLDL lipoproteins (transport of endogenous and rich in tryglycerides)
IDL lipoproteins
LDL lipoproteins (converted form VLDL)
HDL lipoproteins (important for transporting LDL back to liver)

Question 7

How is triglycerides transported in the blood?

Answer 7

Carried in the blood by VLDL.

Question 8

In which diseases do you see an excess of triglycerides?

Answer 8

Diabetes and familial hypercholesterolemia.

Question 9

What are the different treatment options for an excess triglycerides?

Answer 9

Diet, Niacin, Fibrates and Statins.

Question 10

What factors cause hypercholesterolemia

Answer 10

Genetic (familial hypercholesterolemia), secondary (nephrotic syndrome, obstructive jaundice, alcohol, obesity, medication, dialysis) and environmental factors (obesity, dietary choices)

Question 11

True or false: Familial hypercholesterolemia is the most common inherited condition affecting the vascular system.

Answer 11

True

Question 12

Which other tissues does familial hypercholesterolemia affect?

Answer 12

Tendons (tendon xanthomas), skin, e.g. eyelids (xanthelasmata), and eye on the cornea (arcus cornealis)

Question 13

Explain the cause behind familial hypercholesterolemia.

Answer 13

Mutations in the LDRL gene, basically results in high levels of cholesterol in the blood. As well as environmental factors.

Question 14

What other diseases is Low Density Lipoproteins (LDL) related to?

Answer 14

Associated with atherosclerosis. Higher the LDL the higher the risk of atherosclerosis.

Question 15

What is another term used for LDL?

Answer 15

“Bad cholesterol”

Small dense LDL cholesterol particles is the bad cholesterol. The big fluffy LDL is not bad.

Question 16

What are the optimal levels of LDL in the blood?

Answer 16

Lower is better, optimal levels <2.6 mmol/l

This level advocates as a target for patients with atherosclerosis.

Question 17

What are the treatment options for patients with increased/high levels of LDL?

Answer 17

Statins, Ezetamide, Niacin, Plant sterols

Question 18

Describe the role of High Density Lipoprotein (HDL).

Answer 18

Removes LDL from the blood stream to the liver. High HDL is associated with a decreased risk of atherosclerosis.

Question 19

What factor increases HDL, and what factors decreases HDL?

Answer 19

Aerobic exercise increases HDL.

Smoking lowers HDL.

Question 20

What are some of the factors affecting cholesterol levels?

Answer 20

Diet
Weight
Exercise
Age
Gender 
Diabetes
Heredity
Other, such as medications, medical conditions.

Question 21

Hypercholesterolemia is a major risk factor for which conditions?

Answer 21

Heart disease and stroke.
Coronary artery disease.
Peripheral vascular disease.
Link with hypertension.

Question 22

How do you diagnose hypercholesterolemia?

Answer 22

Screening: lipoprotein profile

Question 23

What are some of the treatment options for hypercholesterolemia?

Answer 23

Lifestyle modification; Diet (nuts, omega 3, fatty fish); Exercise; Weight loss; Medication