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Clinical Chemistry > Lipids > Flashcards

Lipids Flashcards

1
Q

Lipids are commonly referred to as ______.

A

Fats

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2
Q

Two Building blocks of Lipids

A

Glycerol

Fatty Acids

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3
Q

Lipids are ______ to water and blood, but is soluble to _______ compounds.

A

Insoluble to water and blood

Soluble to Organic Compounds

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4
Q

Major transport protein of Lipids

A

Lipoproteins

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5
Q

Principle of Lipoproteins based on Size and Density

A

Mas MALAKI mas MAGAAN (vice versa)

Rationale:
Lipids are Large
Proteins are Dense

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6
Q

Major Lipoproteins

A

Chylomicrons
VLDL
LDL
HDL

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7
Q

Major Lipids of the Body

A 
Fatty Acid
Glycerol
Phospholipid
Cholesterol
Vitamins A-D-E-K
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8
Q

Storage Form of Lipids

A

Tryglyceride

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9
Q

Routine Tests for Lipids

A

Cholesterol and TAG

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10
Q

Vitamins A, D, E, K are _________ vitamins and tests for ___________ function.

A

ADEK are Lipid Soluble Vitamins

Tests for Liver Synthetic Function

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11
Q

Lipids are always extracted by using _____________ before you can/should analyze them.

A

Bloor’s Reagent

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12
Q

___________ is used for evaluation of risk to Coronary Heart Disease (CHD)

A

Lipid Profile

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13
Q

_______ is the major constituent of TAG and phospholipid that are linear chains of C-H bonds with COOH at terminal end

A

Fatty Acid

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14
Q

Classification of F.A based on Number of Chains

Short Chain:
Medium Chain:
Long Chain:

A

Classification of F.A based on Number of Chains

Short Chain: 4-6
Medium Chain: 8-12
Long Chain: >12

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15
Q

Classification of F.A based on Chemical Bond

Saturated:
Unsaturated:

A

Classification of F.A based on Chemical Bond

Saturated: Singe Bond (FatS - Solid - TranS )
Unsaturated: Double Bonds (Oil - Liquid - Cis)

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16
Q

Building blocks for TAG and Phospholipid

A

Fatty Acid

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17
Q

Most abundant type of Lipid

A

Phospholipid

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18
Q

Phospholipid contains __________ + ________

A

2 F.A + 1 Phosphorylated Glycerol

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19
Q

3 Forms of Phospholipid

*arrange by percentage

A

70% - Lecithin
20% - Sphingomyelin
10% - Cephalin

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20
Q

Phosphatidylcholine

A

Lecithin

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21
Q

Phosphotidylethenolamine

A

Cephalin

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22
Q

Lung Surfactant Material

A

Sphingomyeline

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23
Q

Sphingomyelin is ___________, but a form of an amino alcohol called ___________.

A

Non-glycerol derived

Sphingosine

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24
Q

Sphingomyelin is increased in ____________ disorder by accumulation in the liver and spleen (Lipid Storage disorder)

A

Niemans Pick

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25
Q

This tests for Fetal Lung Maturity

A

L/S Ratio

Phosphatidyl Glycerol

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26
Q

Estimation of Serum Lipid Phosphorus

A

Phosphorus Conc. x 25

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27
Q

Sphingomyelin serves as a reference material during __________.

A

3rd trimester

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28
Q

Lecithin vs. Shingomyelin

  • Pulmonary ________
  • Synthesized by baby until/only
A

Lecithin

Pulmonary Lubricant
Synthesized till birth

Sphingomyelin

Pulmonary Surfactant
Synthesized ONLY during 1st trimester (constant)

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29
Q

TAG comprises of ___ F.A + _______________

A

3 F.A + 1 Glycerol

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30
Q

*TAG begins to rise after _________

A

2 hrs

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31
Q

Neutral Fat

A

Triglyceride

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32
Q

Triglyceride is increased in cases of __________ with the value of ____________ mg/dL.

A

Acute Pancreatitis - >500/>680 mg/dL

Rationale: Pancreas is only organ that produces the enzyme (LPL), Lipase that breaks down Lipids. The reason also why Lipase is more specific than AMS.

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33
Q

TAG value which Milky Serum is seen

A

200 - 499/ >500 mg/dL

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34
Q

TAG Fasting

A

12 - 14 hrs

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35
Q

Two main sources of TAG

A

Chylomicrons (Exogenous) - 80% - 95% TAG

VLDL (Endogenous) - 50% - 65% TAG

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36
Q

TAG value at risk for CHD

A

> /= 200 mg/dL

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37
Q

TAG and Cholesterol is tested in adults at least once in every _____

A

5 years

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38
Q

Classical Method in TAG measurement

A

Van Handel & Zilversmith

39
Q

Reference Method in TAG measurement

A

MODIFIED Van Handel & Zilvertsmith

*Modified: Adsorption (Additional Step) - Sialic Acid

40
Q

TAG Chemical Method - Colorimetric vs. Fluorometric

Method:
Reagent:
End Product:

A

Colorimetric Method

Method: Van Handel & Zilversmith
Reagent: Chromotropic acid
End Product: Blue

Fluorometric Method

Method: Hantzsch Condensation
Reagent: Diacetyl acetone + NH3
End Product: Yellow (Diacetyl Lutidine Compound)

41
Q

Van Handel & Zilversmith Method vs. Modified Van Handel & Zilversmith

Van Handel & Zilversmith
Step 1: Extraction - \_\_\_\_\_\_\_\_
Step 2: \_\_\_\_\_\_\_ - KOH
Step 3: Oxidation - Periodic Acid
Step 4: Color Reaction - \_\_\_\_\_\_\_\_\_

End Product - ________

Modified Van Handel & Zilversmith
Step 1: Extraction - \_\_\_\_\_\_\_\_
Step 2: \_\_\_\_\_\_\_ - \_\_\_\_\_\_\_
Step 3: \_\_\_\_\_\_\_ - KOH
Step 4: \_\_\_\_\_\_\_ - Periodic Acid

End Product - ________

A

Van Handel & Zilversmith

Step 1: Extraction - Bloor’s Reagent
Step 2: Hydrolysis - KOH
Step 3: Oxidation - Periodic Acid
Step 4: Color Reaction - Chromotropic acid

End Product - BLUE

Modified Van Handel & Zilversmith
Step 1: Extraction - Chloroform
Step 2: Adsorption - Sialic Acid
Step 3: Hydrolysis - KOH
Step 4: Oxidation - Periodic Acid

End Product - PINK

42
Q

Fasting - Chilomicrons

43
Q

TAG - Enzymatic Methods
Glycerol Kinase Method

Reaction A: _____________
Reaction B: _____________

A

TAG - Enzymatic Methods
Glycerol Kinase Method

Reaction A: Pyruvate Kinase Method
Reaction B: Glycerol Phosphate Dehydrogenase Method

44
Q

Reaction A vs. Reaction B

Step 1: TAG - lipase - FA & GLYCEROL
Step 2: GLYCEROL
Step 3:
Step 4:

Measured -

A

Reaction A

Step 1: TAG - lipase - FA & GLYCEROL
Step 2: GLYCEROL + ATP - glycerol kinase - Glycerophosphate + ADP
Step 3: ADP + Phosphoenol pyruvate - pyruvate kinase - Pyruvate + ATP
Step 4: Pyruvate + NADH - lactate dehydrogenase - Lactate + NAD

Measured - NAD

Reaction B
Step 1: TAG - lipase - FA & GLYCEROL
Step 2: GLYCEROL + ATP - glycerol kinase - Glycerophosphate + ADP
Step 3: Glyerphosphate + NAD - glycerphosphate dehydrogenase - Dihydroxyacetone phosphate + ATP
Step 4: NAD + Tetrazolium dye - diaphorase - Formasan + NAD+

Measured - Formasan

45
Q

*Patients with 50-60 yrs old increases TAG for ______ per year.

46
Q

Increased TAG:

Decreased TAG:

A

Increased TAG: Pancreatitis, Hypothyroidism

Decreased TAG: Hyperthyroidism, Stroke

47
Q

Cholesterol is an __________________ with 4 rings and 1 side chain of C-H bond of FA

A

Unsaturated steroid alcohol

48
Q

_____ ring is the hydrophilic region of cholesterol

49
Q

Most Atherogenic Lipid substance

A

Cholesterol

50
Q

___% of cholesterol are found endogenously

51
Q

Two forms of Cholesterol

70%: ______________
30%: ______________

A

Two forms of Cholesterol

70%: Cholesterol Esters
30%: Free Cholesterol

52
Q

Cholesterol is directly related to ____________, _________, and ________________

A

Atherosclerosis
AMI
Coronary Arterial Occlusions

53
Q

Functions of Cholesterol

A
  1. Steroid Precursors - Aldosterone, Cortisol, Progesterone, Estrogen, Testosterone
  2. Bile acids
  3. Vit. D
54
Q

*Recommended age Group Points - Serum Cholesterol
Age - Moderate Risk - High Risk

2-19: ____ : >185
__ - __: ____: 220
30-39: 220: 240
>40: ___: ___

A

Recommended age Group Points - Serum Cholesterol
Age - Moderate Risk - High Risk

2-19: >170 : >185
20-29 - >200: >220
30-39: >220: 240
>40: >240: >260

55
Q

Hyperthyroidism: ______ TC and TAG
Hypothyroidism: _______ TC and TAG

A

Hyperthyroidism: Decrease TC and TAG
Hypothyroidism: Increase TC and TAG

56
Q

Chemical Method - Cholesterol

Lieberman vs. Salkowski
End Product:
Color:

A

Liebermann Burchardt

End Product: Cholestadienyl MONOsulfonic acid
Color: GREEN

Salkowski

End Product: Cholestadienyl DIsulfonic acid
Color: RED

57
Q

________ is most routinely used THREE step method.

A

Abel-Kendall Method (Extraction > Saponification > Colorimetry)

58
Q

General Reaction of Chemical Method in Cholesterol Determination
Reaction - Reagent

Step 1: ________ - Bloor’s/Chloroform/Hexane
Step 2: Saponification - ____
Step 3: Purification/Precipitation - _______
Step 4: ________ - Lieberman: ____________
Salkowsky: ____________

A

General Reaction of Chemical Method in Cholesterol Determination
Reaction - Reagent

Step 1: Extraction - Bloor’s/Chloroform/Hexane
Step 2: Saponification/Hydrolysis - KOH
Step 3: Purification/Precipitation - Digitonin
Step 4: Colorimetry - Lieberman: Acetic anhydride - sulfuric acid
Salkowsky: Ferric-sulfuric acid

59
Q

CDC Reference Method for Cholesterol

A

Abell, Levy, Broody Method

60
Q

Abell, Levy, Broody Method chemical reaction

A

It uses HEXANE for extraction with ALCOHOLIC KOH and followed by LB reagent.

61
Q

It is currently the ROUTINE/WORL WIDE most common method for Cholesterol Measurement.

A

Enzymatic Method - Cholesterol Oxidase Method

62
Q

In every ____ mg/dl presence of BILIRUBIN will ________ cholesterol by 5-15%

A

> 5 md/dl of Bilirubin will DECREASE cholesterol by 5-15%

63
Q

New reference method for Cholesterol Measurement

A

Mass Spectrophotometry

64
Q

Lipoprotein is a complex of lipids and ___________.

A

Apolipoprotein

65
Q

Transports TAG - __________, _______

Transports Cholesterol - ______, ______

A

Transports TAG - Chylomicrons, VLDL

Transports Cholesterol - HDL, LDL

66
Q

Major Carriers of Lipoproteins

Apo A1: \_\_\_\_\_
Apo B100: \_\_\_\_\_
Apo B48: \_\_\_\_\_\_
Apo E: \_\_\_\_\_
Apo C: \_\_\_\_\_
A

Major Carriers of Lipoproteins

Apo A1: HDL
Apo B100: LDL, VLDL
Apo B48: Chylomicrons
Apo E: Binds to LDL-receptor and Remnant receptor
Apo C: Activate LPL
67
Q

Alternative pathway for HDL metabolism

A

Cholesterol Ester Transport Protein Pathways (CTEP)

68
Q

Lipoprotein Composition
TAG - CE - Protein

Chylomicrons - 80-95; 2-4; __
VLDL - ____; 16-22; 6-10
LDL- 4-8; ____; _____
HDL - 2-7; ____; ____

A

Chylomicrons
TAG- 80-95
CE - 2-4
CHON - 1-2

VLDL
TAG - 45-65
CE - 16-22
CHON - 6-10

LDL
TAG - 4-8
CE - 45-55
CHON - 18-22

HDL
TAG - 2-7
CE - 15-20
CHON - 45-55

69
Q

Chylomicrons

A

Most non-atherogenic
Largest - Lightest
Transport EXOgenous TAG

70
Q

Chylomicrons are completely cleared in the plasma after _______ of fasting

71
Q

VLDL

A

Atherogenic transporter of TAG
Pre-beta Lipoprotein
Transport ENDOgenous TAG

72
Q

LDL-C

A 
Most Atherogenic
Beta Lipoprotein
Bad Cholesterol
Transports Cholesterol from Liver to Cells (Liver --chlesterol -- Cells/tissues)
Forward Cholesterol Transport
Indirectly Measured - Friedwald
73
Q

HDL-C

A 
Alpha Lipoprotein
Good Cholesterol "Cardioprotective"
Smallest - Most Dense
Transport Cholesterol from Cells to the Liver (Cells -- cholesterol -- Liver)
Reverse Cholesterol Transport
74
Q

_____ is the primary target of Cholesterol Lowering Therapy because in every 1% decrease in LDL is ____ decrease in Cholesterol

A

LDL - 1% decrease of LDL is 2% decrease of Cholesterol

75
Q

IDL

A

Product of VLDL Catabolism
Converted to LDL
Intermediate of VLDL and LDL

76
Q

IDL is only found in patients with _______________, due to defective clearance from the deficiency of ________.

A

Px: Type III Hyperlipoprotenemia
Deficiency: Apo E3

77
Q

Lipoprotein (a)

Mnemonics: *a-anchor&raquo_space;> sinks

A

LDL-like variant
Sinking pre-beta lipoprotein
INDEPENDENT risk factor for atherosclerosis
Increase in premature CHD and Stroke

78
Q

Lipoprotein X

A

Px: Obstructive jaundice and LCAT deficiency
Marker: Cholestasis
Major Component: 90% Phospholipid and Free Cholesterol

79
Q

B-VLDL

Mnemonics: B - boat&raquo_space;> Floats

A

Floating pre-beta lipoprotein
Abnormally migration B-VLDL
Cholesterol rich VLDL
Px: Type III Hyperlipoproteinemia/Dysbetalipoproteinemia

80
Q

Posture of patients should needed to be seated for ____ minutes prior to sampling because standing patients have ____ decreased total cholesterol, HDL, and LDL

A

Posture of patients should needed to be seated for 5 minutes prior to sampling because standing patients have 10% decreased total cholesterol, HDL, and LDL

81
Q

HyperChylomicronemia

Defect: _________
Findings: TAG - _________ mg/dL
Absent: _____

A

HyperChylomicronemia

Defect: LPL Deficient
Findings: TAG - 10, 000 mg/dl
Absent: Apo C

82
Q

HyperCholesterolemia (Type 2a)

Defect: LDL receptor deficient
Manifestation: Xanthelasma, Planar Xanthomas

A

HyperCholesterolemia (Type 2a)

Defect: ___________
Manifestation: _____________

83
Q

Hyperlipoprotenemia

a.k.a ___________
Present: ___________

A

Hyperlipoprotenemia

a.k.a Dysbetalipoprotenemia
Present: B-VLDL, IDL and Apo E (no clearing of remnants)

84
Q

Abetalipopotenemia
a.k.a _______________

Defect: ___________
Absent: ____, ____, ____
Low: ____________

A

Abetalipoprotein “Bassen Korzweig Sydrome”

Defect: Apo B synthesis defect
Absent: VLDL, LDL, CM
Low: Cholesterol, TAG, ApoB
*Manifestation: Acanthocytosis

85
Q

Tangier’s Disease is a.k.a _________________

A

Analphalipoproteinemia/Hypoalphalipoproteneinemia

86
Q

Defect in Tangier’s Disease

A

Defect: HDL deficiency; Absent ABC A1 gene

87
Q

Anderson’s Disease is a.k.a ________________

A

Chylomicron Retention disease

88
Q

Defect in Anderson’s disease

A

Defect: Apo B48 deficiency resulting to FAT MALABSORPTION

89
Q

b-glucocererbrosidase deficiency

A

Gaucher Disease

90
Q

Hexosaminidase deficiency

A

Tay Sach’s

91
Q

alpha-galactosidase deficiency

A

Fabry disease

92
Q

Sphingomyelinase deficiency

A

Niemann-Pick disease

93
Q

LCAT deficiency is present with ___________ and manifested with ____________

A

Present: Lipoprotein X
Manifestation: Fish Eye

94
Q

_____________ is where phytosterols are absorbed and accumulate in plasma.

A

SITOsterolemia

Clinical Chemistry (20 decks)

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