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Chest pain > Investigation and risk factors for ischaemic heart disease and myocardial infarction (2) > Flashcards

Investigation and risk factors for ischaemic heart disease and myocardial infarction (2) Flashcards

1
Q

What are lipids?

A

Lipids are organic biomolecules which are soluble in NON-POLAR
solvents and much less soluble in water

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2
Q

What are major lipids in the plasma?

A

Fatty acids (FA)
Triacylglycerols (triglycerides) (TG or TAG)
Cholesterol
Phospholipids

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3
Q

What is a more efficient storage of energy: triacylglycerols or glycogen

A

triacylglycerols

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4
Q

Where is triacylglycerols formed?

A

Liver

Adipose tissue

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5
Q

Where do triacylglycerols come from?

A

Metabolites from glycolysis (DHAP — dihydroxyacetone phosphate) form TAGs in the FED state

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6
Q

How are triacylglycerols broken down- into what?

A

Breakdown of TAGs is the first stage in fatty acid metabolism, resulting in release of FFA (free fatty acids)

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7
Q

How is ATP derived from triacylglycerols

A

Resultant fatty acids then undergo B-oxidation and ATP production

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8
Q

What keeps the metabolism of triacylglycerols regulated?

A

triglyceride lipase

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9
Q

How is cholesterol synthesised?

A

Acetyl CoA -> HMG CoA (Intermediate)- Mevalonate

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10
Q

Where is cholesterol synthesised?

A

Liver

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11
Q

How is the synthesis of cholesterol regulated

A

HMG CoA Synthase

HMG CoA Reductase

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12
Q

How do statins affect synthesis of cholesterol

A

statin is an HMG-CoA reductase inhibitor

stops the liver from synthesizing cholesterol

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13
Q

How do lipids travel around the body?

A

Lipoproteins

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14
Q

What is the lipoprotein made of structurally?

A

Surface coat

Lipid core

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15
Q

What is contained in the surface coat of the lipoprotein

A

unesterified cholesterol
phospholipids
apolipoproteins

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16
Q

What is contained in the lipid core of the lipoprotein

A

cholesteryl esters

triglycerides

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17
Q

What is the role of apolipoproteins

A

Signals which lipoproteins it is

18
Q

What are the types of lipoproteins?

A 
Chylomicrons
VLDL
IDL
LDL
HDL
19
Q

What is Chylomicrons mostly made of? least made of?

A

Triglyceride- H

Protein-L

20
Q

What is HDL mostly made of? least made of?

A

Triglyceride- L

Protein-H

21
Q

What is LDL mostly made of? least made of?

A

Cholesterol- H

Triglyceride-L

22
Q

What is chylomicrons a major transport form of?

A

Dietary fat being absorbed from the gut

23
Q

What is the chylomicrons transport pathway also known as?

A

Exogenous pathway

24
Q

What percentage of triglycerides is in chylomicrons?

A

90%

25
Q

How is triglyceride removed from chylomicrons?

A

Lipoprotein lipase

26
Q

What does chylomicrons transport?

A

cholesterol and fat-soluble vitamins Dietary fat

27
Q

What is chylomicron metabolism(exogenous pathway)?

A

Fat broken down into triglycerides so forms chylomicron
triglyceride released from it by lipoprotein lipase
Gets smaller becomes a chylomicron remnant and cholesteryl esters is added
Cleared by liver from circulation and excreted into the bile

28
Q

In the chylomicron metabolism where does the cholesteryl ester come from?

A

HDL

29
Q

What is the VLDL metabolism known as?

A

Endogenous pathway

30
Q

What is VLDL a major transport form of?

A

Endogenous triglyceride

31
Q

Where is VLDL formed?

A

Liver

32
Q

How is triglyceride removed from VLDL?

A

Lipoprotein lipase

33
Q

VLDL metabolism?

A

Triglyceride removed by Lipoprotein lipase to make IDL
More triglyceride removed with hepatic triglyceride lipase to form LDL
LDL taken up by liver through LDL receptors or can be transported to peripheral tissues

34
Q

How is LDL made?

A

From VLD via IDL

35
Q

How does LDL contribute to atherosclerosis?

A

Binds to LDL receptors on cell membranes — then are broken down releasing cholesterol

Uptake of LDL in the arterial wall contributes to ATHEROSCLEROSIS

36
Q

Where is HDL synthesised?

A

Liver

37
Q

What is HDL initially synthesised as?

A

Nascent HDL

38
Q

What is HDL metabolism also known as?

A

Reverse cholesterol transport

39
Q

HDL metabolism?

A

Nascent HDL delivered with cholesterol from peripheral tissues to form HDL
Cholesterol esterified by Lecithin cholesterol acyl transferase

Cholesterol esters are then delivered from HDL into the chylomicron remnants
HDL returned to circulation

40
Q

What does Nascent HDL look like?

A

flat cylinder

41
Q

What are the lipid disorders that we need to know?

A

Familial hypercholesterolaemia
Type III hyperlipidaemia
Hypertriglyceridemia

Chest pain (8 decks)

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