Lipids

Question 1

total cholesterol

Answer 1

<200mg/dL

Question 2

LDL

Answer 2

<130mg/dL

Question 3

HDL

Answer 3

> 60mg/dL

Question 4

VLDL

Answer 4

not measured

Question 5

LDL:HDL RATIO

Answer 5

3.0-3.5:1

Question 6

LP(a)

Answer 6

-

Question 7

triglycerides

Answer 7

<165mg/dL

Question 8

bile acid sequestering agents

Answer 8

cholestyramine, cholestipol

Question 9

nicotinic acid

Answer 9

niacin

Question 10

HMG co-A reductase inhibitors

Answer 10

lovastatin, simvistatin, pravastatin, fluvastatin, atorvastatin, cerivastatin

Question 11

fibric acid derivatives

Answer 11

gemfibrozil, clofibrate, fenofibrate

Question 12

bile seq agents MOA

Answer 12

1. binds to bile acids in sm intestine (poop out)
2. liver must use intracellular chol stores to make more bile acids
3. to replenish intracellular chol, liver takes in more plasma chol=lower plasma cholesterol (LDL)

Question 13

niacin MOA

Answer 13

1. inhibits lipolysis in adipocytes
2. so decreased hepatic VLDL synthesis
3. so decreased VLDL==decreased LDL

Question 14

HMG CoA reductase inhibitor MOA

Answer 14

in liver, HMG CoA reductase is required to make cholesterol de novo–statins inhibit this, lowering intracellular cholesterol, increasing LDL receptors and uptake of LDL out of the blood; also lowers secretion of VLDL into blood

Question 15

Fibrates MOA

Answer 15

increase lipoprotein lipase=decrease plasma cholesterol
decrease apo C2=decrease plasma cholesterol
increased expression of apo A1 & 2=increase in plasma HDL

Question 16

Omega-3-Acid Ethyl Esters MOA

Answer 16

reduce synthesis of triglycerides in liver by limiting enzymes

Question 17

bile seq agents effects

Answer 17

• significant LDL lowering effects (less than statins)
• small increase in HDL
• little to no effect TG

Question 18

HMG CoA reductase inhibitors (statins) effects

Answer 18

• significant (BEST) LDL lowering effects
• modest increase in HDL
• modest decrease TG

Question 19

Fibrates effects

Answer 19

• small LDL lowering effect
• significant HDL increase
• significant TG decrease

Question 20

Niacin effects

Answer 20

• modest decrease LDL
• significant HDL increase
• significant TG decrease

Question 21

metabolic syndrome

Answer 21

at least 3 of the following:

1. increased abdominal circumference
2. elevated BP
3. elevated TG
4. elevated sugar
5. decreased HDL

Question 22

Familial hypercholesterolemia

Answer 22

cell surface receptors for LDL molecule absent/defective=unregulated synth of LDL

homozygotes: ~8x normal level of LDL (atherosclerotic disease in childhood)
heterozygotes: ~2x normal LDL, develop CHD in 30’s or 40’s

Question 23

familial hyperchylomicronemia

Answer 23

abnormality of lipoprotein lipase (enzyme that enables peripheral tissues to take up TG from chylomicrons and VLDL particles)
-these patients have marked hyperTGemia with recurrent pancreatitis and hepatosplenomegaly in childhood