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DS Unit 4 > Lipid Panel > Flashcards

Lipid Panel Flashcards

1
Q

What are the 4 types of lipoproteins? What are they primarily made of?

A
  1. Chylomicrons (primarily triglycerides)
  2. LDLs (primarily cholesterol)
  3. VLDLs (primarily triglycerides)
  4. HDLs (protein with small amount cholesterol)
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2
Q

How much cholesterol is in HDLs? How much protein and phospholipids?

A

20% cholesterol
50% protein
30% phospholipids

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3
Q

Where are HDLs produced?

A

Liver and intestines

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4
Q

What are the functions of HDLs?

A
  1. Remove cholesterol from peripheral tissues and endothelium
    A. Transport cholesterol to liver for excretion
  2. Protective mechanism for heart disease, protect coronary arteries
    A. Reverse cholesterol transport
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5
Q

What is the clinical application of high HDL levels?

A

Increased cholesterol excretion

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6
Q

What is the % composition of LDLs?

A
  1. 45% chol,
  2. 25% prot,
  3. 10% trigs,
  4. 20% phospholipids
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7
Q

What is the function of LDLs?

A
  1. Cholesterol carried by LDLs can be deposited into peripheral tissues
    A. Leads to increased risk of atherosclerotic heart and peripheral vascular disease
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8
Q

Describe the structure of an LDL

A

a globular micelle-like particle that consists of a nonpolar core of triacylglycerols and cholesterol esters surrounded by an amphiphilic coating of protein, phospholipid, and cholesterol, approx 25 nanometers

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9
Q

What is the function of VLDLs?

A

Primary function is to transport triglycerides to peripheral tissues

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10
Q

What % of VLDL is triglycerides?

A

70%

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11
Q

What are the clinical uses for VLDLs?

A
  1. Useful predictor of coronary outcomes

2. Used as a secondary target of treatment

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12
Q

What is the equation for total cholesterol?

A

VLDL + LDL + HDL = Total Cholesterol.

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13
Q

What happens to VLDL in the bloodstream?

A

VLDL is converted to IDL, and then to LDL, in the bloodstream. (VLDL –> IDL –> LDL)

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14
Q

What % of chylomicrons is triglycerides?

A

90%

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15
Q

What is the function of trigylcerides?

A

1.Carry absorbed lipids from intestinal tract to bloodstream.
2. Transport exogenous lipids to liver, adipose, cardiac, and skeletal muscle tissue
A. Triglycerides then broken down by lipase into gylcerol and fatty acids

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16
Q

Describe the structure of a chylomicron

A

Phospholipid shell with triglycerides on the interior

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17
Q

What is the function of lipoproteins (general)?

A

Transport cholesterol, triglyceride and other insoluble fats to a location where it is utilized

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18
Q

What are fats used for?

A 
1. Synthesis of steroid hormones
A. Adrenal
B. Gonadal
2. Making cell membranes
3. Making bile
19
Q

What is tested in a lipid profile?

A
  1. Total Cholesterol
  2. Triglycerides
  3. HDL
  4. LDL
  5. VLDL
  6. Cardiovascular risk ratio
20
Q

What are the indications for testing total cholesterol?

A

Identify patients at risk for atherosclerotic heart disease

Usually done as part of lipid profile testing bc need to know components of the total cholesterol

21
Q

What is the main lipid associated with vascular disease?

A

Cholesterol

22
Q

Where is cholesterol metabolized?

23
Q

How is cholesterol transported through the blood stream?

A
  1. 25% bound to HDL
  2. 75% bound to LDL
    A. LDL most directly associated with increased risk CHD
24
Q

What are subnormal cholesterol levels indicative of?

A

Severe liver disease

25
Q

What are the normal adult/elderly RI for cholesterol?

A

<200 mg/dl

26
Q

What are hte normal childhood RI for cholesterol?

A

120 – 200 mg/dl

27
Q

Where are the triglycerides produced? What are the building blocks?

A

Trigs are produced in liver

Glycerol and other fatty acids building blocks

28
Q

What is the function of triglycerides?

A

Storage source of energy

29
Q

Where are triglycerides deposited if levels increase?

A

Deposited in fatty tissue

30
Q

What are the indications for triglyceride testing?

A
  1. Identify risk of developing coronary artery disease: obese, diabetics
  2. Suspected fat metabolism disorders:
    A. Malabsorptive problems: may have low levels
31
Q

Normal RI for elderly and adult triglycerides?

A

Male: 40 – 160 mg/dl
Female: 35 – 135 mg / dl

32
Q

What are the RI for children?

A

0 – 5 years: 30 – 99 mg / dl
6 – 11 years: 31 – 114 mg / dl
12 – 15 years: 36 – 138 mg / dl
16 – 19 years: 40 – 163 mg / dl

33
Q

what conditions can cause increased triglycerides? Why?

A
  1. Familial hypertriglyceridemia
  2. Hyperlipidemia: as lipids inc, so do trigs
  3. Hypothyroidism: catabolism of trigs dec
  4. High Carc diet: excess carbs converted into trigs.
  5. Poorly controlled DM: inc synthesis of tgl carrying VLDL and dec catabolism at same time.
  6. Nephrotic Syndr: loss of proteins dec plasma oncotic pressure; this stimulates synth VLDL & LDL.
  7. CRF: Insulin levels high because insulin excreted by kidney. Insulin inc lipogenesis and inc trigs.
34
Q

What conditions will cause decreased triglycerides?

A
  1. Malabsorptive syndrome: mal of fat; since trigs major component fat, trigs dec.
  2. Malnutrition: dec fat in diet
  3. Hyperthyroidism: catabolism VLDL inc, therefore Trgs dec
35
Q

What are the indications for lipoprotein analysis?

A
  1. Identify patients at risk of developing heart disease

2. Monitor lipid therapy

36
Q

What are the normal adult HDL ranges?

A

Male: > 45 mg/dl
Female: > 55 mg/dl

37
Q

What are the normal adult LDL ranges?

A

60 – 180 mg/dl

38
Q

What are the normal VLDL ranges?

A

7 – 32 mg/dl

39
Q

When are HDL levels increased?

A
  1. Excessive exercise
    A. HDL normally rises with exercise for 30 mins 3X/week; when exercise greatly exceeds that minimum, HDL can become significantly elevated
  2. Familial HDL lipoproteinemia
40
Q

When are HDL levels decreased?

A
  1. Metabolic Syndrome: high fasting glucose, waist circumference, HDL/LDL ratio, increased blood pressure, high triglycerides
  2. Familial low HDL
  3. Hepatocellular Disease: HDL made in liver. Without nl liver fxn, HDL is not made and levels fall
  4. Hypoproteinemia: nephrotic syndr, malnutrition: with loss proteins, HDL is not made and levels fall
41
Q

When are LDL and VLDL levels increased?

A
  1. Nephrotic Syndrome: loss of proteins dec plasma oncotic pressure. Stimulates hepatic synthesis of LDL.
  2. Hypothyroidism: VLDL & LDL catabolism is decreased. Common cause of lipid abnormalities.
  3. Alcohol consumption: hyperlipidemias noted in pts who drink excessive alcohol
  4. Chronic Liver Disease: liver catabolizes LDL; without that catabolism, blood levels inc
  5. Familial LDL lipoproteinemia
  6. FAmilial hypercholesterolemia type IIa
42
Q

What causes decreased LDL and VLDL levels?

A
  1. Hypoproteinemia: malabsorption, severe burns, malnutrition.
  2. Hyperthyroidism: catabolism of LDL and VLDL is inc and levels fall
  3. Familial hypoliporoteinemia
43
Q

What is the ideal total cholesterol/HDL ratio?

A

less than 4:1

44
Q

What does the total chol/HDL ratio measure?

A

measure of risk with regard to atherosclerosis

DS Unit 4 (9 decks)

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