Lecture 11 - Introduction to Dyslipidaemias and Atherosclerosis

Question 1

Define atherosclerosis

Answer 1

A progressive disease of large and medium-sized muscular arteries characterised by inflammation and dysfunction of the lining of the involved blood vessels and the build-up of cholesterol, lipids, cellular debris
Results in formation of a plague
Obstruction of blood flow
Diminished oxygen supply to target organs
Can lead to complete occlusion or partial rupture of these deposits - leads to thrombosis
Limited space - less nutrients around the body

Question 2

Clinical signs and symptoms of atherosclerosis

Answer 2

Many cases are symptomatic
CHD
Cerebrovascular atherosclerotic disease - leading to TIA
Renovascular disease
Peripheral artery disease
Abdominal aortic aneurysm

Question 3

Name the modifiable risk factors

Answer 3

hypertension
diabetes melitus
smoking
alcohol excess
lack of exercise
high-fat diet
obesity

Question 4

Name non-modifiable risk factors

Answer 4

Gender, Age, Genetics

Question 5

What is dyslipidaemias secondary to?

Answer 5

Liver diseases (jaundice)
Nephrotic syndrome
Anorexia nervosa
Hypothyroidism
Drugs:
- anabolic steroids
- diuretics
- immunosuppressants
- beta-blockers

Question 6

What raised plasma markers are seen in atherosclerosis?

Answer 6

C-reactive plasma (CRP)
Homocysteine
Coagulation factors
Lipoprotein (a)

Question 7

Define LDL

Answer 7

Low-density lipoprotein
Core of approx 1500 cholesterol esters
Low protein-to-cholesterol ratio
small apolipoprotein - B-100
small size

Question 8

Define HDL

Answer 8

High-density lipoprotein
Enriched with non-stratified cholesterol
High protein to cholesterol ratio

Question 9

Define chylomicrons (CM)

Answer 9

Mainly dietary triglycerides and esterified cholesterol
Large size
Packed in endothelial cells in the gut

Question 10

Define VLDL

Answer 10

Very Low-density lipoprotein
Cholesterol esters and newly synthesised triglycerides
Comes from hepatocytes
Intermediate size

Question 11

Define IDL

Answer 11

Intermediate Density Lipoproteins
Remnants of VLDL stripped of TG by lipase (LPL)
Mainly cholesterol

Question 12

Signs of familial hypercholesterolaemia

Answer 12

Tendons xanthomata
Skin xanthomata
Xanthoma
Corneal arcus

Question 13

Define Lipoprotein a

Answer 13

Cholesterol-rich LDL like APO B and an additional protein apolipoprotein attached via a disulphide bond