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Final Cc > Lipid 2 > Flashcards

Lipid 2 Flashcards

1
Q

Disorders of lipids :

A

Arteriosclerosis
Obesity
Hypertension
Diabetes mellitus
Other abnormalities h hi

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2
Q

Good prognosis:

A

Early detection of deranged blood lipid profile

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3
Q

Indications for Lipid Profile include:

A
  1. ⁃ Screening for primary & secondary hyperlipidemias
  2. ⁃ Monitoring for risk of atherosclerosis 3. ⁃ Monitoring treatment of
    hyperlipidemias/Dyslipidemia
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4
Q

Biological Variations:

A

Age
Sex
Season
Food intake
Medical conditions
Acute illness
Life styles

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5
Q

Patient should fast for _______hours before sampling.

A

12hours

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6
Q

Chylomicrons are cleared within_____hrs and their presence
after 12hrs fast is abnormal.

A

6-9hrs

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7
Q

Chylomicrons are cleared within 6-9hrs and their presence
after _____hrs fast is abnormal.

A

12hrs

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8
Q

Patient to be seated for _______min prior to sampling to prevent
hemoconcentration.

A

5min

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9
Q

Patient to be seated for 5min prior to sampling to prevent ___________

A

hemoconcentration

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10
Q

Prolonged venous occlusion leads to increase in cholesterol conc by

A

10-15%

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11
Q

those who walk for about 4 hours each week have an average cholesterol _________ and HDL-C __________ than inactive persons

A

5% lower and 3.4% higher

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12
Q

Menstrualcycle:-The ____________ and ___________ tend to be highest at midcycle, the time of maximum estrogen secretion - The cyclical variation in cholesterol is not observed with anovulatory cycles.

A

Plasma cholesterol and triglycerides concentration

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13
Q

Plasma is preferred when lipoprotein are measured by:

A
  1. ultracentrifugation
  2. Electrophoretic methods
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14
Q

can be used when it is necessary to store samples for weeks or months.

A

Serum

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15
Q

exert large osmotic effect resulting in falsely low plasma lipid and
lipoprotein concentration.

A

Sodium citrate

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16
Q

because of its high M.W can alter electrophoretic mobility of
lipoproteins.

A

Heparin

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17
Q

is preferred anticoagulant even though TC and TG conc in EDTA plasma
are 3% lower than in serum.

A

Edta (ethylenediaminetetraacetic acid)

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18
Q

Anticoagulant used

A

Heparin
Sodium citrate
EDTA

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19
Q

can be satisfactorily analyzed in frozen samples.

A

Total cholesterol
Total triglycerides
High density of lipoprotein

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20
Q

can also be measured in frozen samples.

A

Apo lipoprotein

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21
Q

Cholesterol Estimation : CHEMICAL METHODS

A

Abell kendall method
Liebermann-burchardt reaction
Bloors method

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22
Q

Abell Kendall Method (Former Reference Method): - Principle: 3 step method

A
  1. Cholesterol is hydrolyzed with alcoholic KOH
  2. Unesterified cholesterol is extracted with petroleum jelly/Hexane
  3. Measured using the L-B Reaction
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23
Q

Liebermann-Burchardt Reaction (L-B Reaction):
Cholesterol + Sulfuric acid + Acetic anhydride —> color

A

Bluish green solution

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24
Q

Bloors Method: - Principle: 2 step

A
  1. Cholesterol is extracted using an alcohol ether mixture
  2. Measured using the L-B Reaction
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25
Q

Former Reference Method of chemical method

A

Abell kendall method

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26
Q

Routine Lab - Assay of Choice

A

Cholesterol oxidase method

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27
Q

Cholesterol Oxidase Method (Routine Lab - Assay of Choice):
Principle:

A

Cholesterol ester + H20 – cholesterol esterase —> Free cholesterol

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28
Q

H202 + 4-aminophenazone – peroxidase  Quinoneimine dye (red) + H20

A

Trinder’s Reaction

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29
Q

Trinders reaction color

A

Red

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30
Q

Cholesterol Estimation: ENZYMATIC METHOD:

A

Cholesterol oxidase method
Trinders method

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31
Q

Trinders method Read at ______ wavelength

A

500nm

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32
Q

Trinders method Linear up to

A

600 - 700mg/dL

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33
Q

ADVANTAGE in comparison to the Chemical Method

A

 Precise and accurate
 Lesser interferences - bilirubin,
ascorbic acid, Hb
 Smaller sample quantity
 Rapid; does not require preliminary extraction step
 Can be used to measure unesterified cholesterol by omitting de-
esterification step
 Mild reagents; better suited for
automated analyzers

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34
Q

DISADVANTAGE

A

 They are not absolutely specific for cholesterol.
 Cholesterol oxidase reacts with other sterols e.g plant sterol
 Ascorbic acid and Bilirubin interfere by consuming H202
 Bilirubin interference can produce falsely high or low values
 Significant only at conc >5mg/dL decreasing Cholesterol values by 5 -
15%

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35
Q

INCREASED CHOLESTEROL

A
  1. Biliary cirrhosis
  2. Hyperlipoproteinemia types
    II, III, V
  3. Nephrotic syndrome
  4. UncontrolledDM
  5. Alcoholism
  6. PrimaryHypothyroidism
36
Q

DECREASED CHOLESTEROL

A

1.
Severe hepatocellular disease (alcoholic liver disease)
2. Malnutrition
3. Severe burns
4. Hyperthyroidism
5. Malabsorption syndrome

37
Q

Specifically measures cholesterol and does not detect related
sterols

A

GC-MS METHOD

38
Q

Specifically measures cholesterol and does not detect related
sterols

A

GC-MS METHOD

39
Q

Shows good agreement with the Definitive Method

A

GC-MS METHOD

40
Q

Precipitating reagents such as divalent cations and
polyanions are used to remove all lipoproteins except HDL

A

Precipitation method

41
Q

PRECIPITATION METHOD: Precipitating reagents such as __________ and
polyanions are used to remove all lipoproteins except HDL

A

divalent cations

42
Q

Lipoproteins are precipitated with polyanions

A

Polyanion precipitation

43
Q

Polyanion

A

heparin
sulfate, dextran sulfate and phosphotungstate

44
Q

Reaction should be in the presence of divalent cations

A

Magnesium
Calcium
Manganese

45
Q

Most commonly for HDL and is reasonably specific.

A

Polyanion precipitation

46
Q

Similar to the HDL-C precipitation method but uses a precipitant that is complexed to magnetic particle

A

Magnetic method

47
Q

Magnetic method: Similar to the HDL-C precipitation method but uses a precipitant that is complexed to ____________

A

magnetic particle

48
Q

This sediments and does not require centrifugation

A

Magnetic method

49
Q

Has been adapted for use in automated clinical chemistry
analyzers

A

Magnetic method

50
Q

It allows the supernatant to be analyzed without the need to remove it from the sedimented complex.

A

Magnetic method

51
Q

The “Three-step Procedure” (Reference method for HDL-C estimation):

A
  1. Ultracentrifugation to remove VLDL
  2. Heparin manganese precipitation to remove LDL
  3. Analysis of supernatant cholesterol by the Abell Kendall assay
52
Q

Uses sequential density
adjustments of serum to fractionate major and minor classes of LP

A

Preparative Ultracentrifugation

53
Q

(non-equilibrium or equilibrium techniques) permits fractionation or several or all classes of LPs in a single run

A

Density gradient methods

54
Q

Use antibody-coated plates specific for epitopes on apolipoproteins both in routine and research lab

A

IMMUNOCHEMICAL METHODS

55
Q

LDL-C Estimation INDIRECT METHODS: calculation method

A

Friedwald equation

56
Q

reserved for samples where Friedewald equation is inappropriate

A

Tedious

57
Q

May be useful in evaluation of type Ill hyperlipoproteinemia

A

Very low density lipoprotein/plasma tg ratio

58
Q

Selectively measures LDL after masking non-
LDL cholesterol, OR

A

Homogenous method

59
Q

By selectively solubilizing LDL

A

Homogenous methods

60
Q

Heaviest electrophoresis

A

High density lipoproteins

61
Q

Lightest electrophoresis

A

Chylomicron

62
Q

Alkaline hydrolysis (saponification) using

A

Alcoholic potassium hydroxide

63
Q

Solvent extraction with chloroform and the extract is treated with __________(chromatography) to isolate TAG

A

silicic acid

64
Q

End color reaction with chromotropic acid, giving rise to a

A

Pink end color

65
Q

Demerit: triglycerides

A

Tedious
GC-MS method

66
Q

Demerit: triglycerides

A

Tedious
GC-MS method

67
Q

Enzymatic method: enzymes

A

Lipase
Glycerol
Glycerol phosphate oxidase

68
Q

an indicator of combined LDL and VLDL concentration

A

Apo B

69
Q

Apo B value

A

<120 mg/dl

70
Q

major protein of HDL

A

Apo A

71
Q

Apo A value

A

120-160mg/dl

72
Q

the variant of LDL, an independent indicator
of CHD risk

A

Lipoprotein (a)

73
Q

Lipoprotein a value

A

<30mg/dl

74
Q

can also be employed but requires a Nephelometer and so not commonly used

A

Immunonephelometric

75
Q

Hyperlipoproteinemias have been classified using the system, which is not commonly used today.

A

Fredrickson-levy classification

76
Q

1) Serum appearance: creamy
2) Total cholesterol: normal
3) Triglyceride: elevated
4)Protein: apo B 48

A

Type I hyperlipoproteinemia: elevated chylomicron

77
Q

1) Serum appearance: clear
2) Total cholesterol: elevated
3) Triglyceride: normal
4)Protein: apo B 100

A

Type IIa hyperlipoproteinemia: increase LDL

78
Q

1) Serum appearance: slight turbid
2) Total cholesterol: elevated
3) Triglyceride: elevated
4)Protein: apo B 100

A

Type IIb hyperlipoproteinemia: increased LDL AND VLDL

79
Q

1) Serum appearance: turbid to creamy layer
2) Total cholesterol: elevated
3) Triglyceride: elevated
4)Protein: apo E 2

A

Type III HYPERLIPOPROTEINEMIA: increased IDL

80
Q

1) Serum appearance: turbid
2) Total cholesterol: normal
3) Triglyceride: elevated
4)Protein: apo B 100 and apo C2

A

Type IV hyperlipoproteinemia: increased VLDL

81
Q

1) Serum appearance: turbid over creamy layer
2) Total cholesterol: slight elevated
3) Triglyceride: severe elevated
4)Protein: apo B 100 & 48

A

Type V hyperlipoproteinemia: increased VLDL and chylomicron

82
Q

Total cholesterol level very low, triglyceride level nearly undetectable, LDL and Apo B-100 absent

A

Abetalipoproteinemia

83
Q

Unable to synthesize apo B-100 and apo B-48, low total cholesterol level and normal to low triglyceride level

A

Hypobetalipoproteinemia

84
Q

Severely elevated triglyceride level and low HDL level

A

Hypoalphalipoproteinemia

85
Q

HDL absent, apo A-I and apo A-II very low levels, LDL low, total cholesterol level low, triglyceride level normal to slightly increased

A

Tangier disease

86
Q

Tangier disease also known as

A

Analphalipoproteinemia

87
Q

Abetalipoproteinemia also known as

A

Bassen kohzheig syndrome

Final Cc (3 decks)

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