Lipids Flashcards

1
Q

Blood Sampling and Storage

A

Biological variation
Fasting
Posture
Type of sample (plasma or serum)
Storage

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2
Q

Biological variation

– Age

A

(↑ Cholesterol )

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3
Q

Biological variation

Sex : women have____ level than men

A

lower

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4
Q

Biological variation

Seasonal what increases during winter

A

(Cholesterol↑ in winter)

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5
Q

Biological variation

Dietary intake (restricted diet for_____)

A

2 weeks

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6
Q

Biological variation

Medications (eg)

A

oral contraceptives
Postmenopausal estrogen
Antihypertensive drugs

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7
Q

Biological variation

A

Age (↑ Chole)
Sex : women have lower level than men
Seasonal (Chole ↑ in winter)
Dietary intake (restricted diet for 2 weeks)
Medications (oral contraceptives)
Medical disorders
Lifestyle and other biological variation
• Recent MI, stroke, cardiac catheterization

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8
Q

TRUE/FALSE : Total Chole, HDL, LDL and TAG can be measured in fasting patients only

A

FALSE!

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9
Q

What can be measured in NON-FASTING individuals

A

– Total Cholesterol

– HDL

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10
Q

What requires FASTING individuals

A

Triglycerides (TAG)
LDL

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11
Q

Fasting

• Ideal time:

A

12 hours

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12
Q

CMs markedly ↑ TAG after meals (clearance time:_______)

A

6 to 9 hours

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13
Q

> 12h fasting = CM -> ???

A

False Increase CM

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14
Q

Some LPP physiologically ↓ after meals due to____ mediated compositional changes that occurs when CM is catabolized

A

CETP

Cholesteryl ester transfer protein

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15
Q

NCEP Adult treatment Panel III: at least____ hours

A

9hrs

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16
Q

Posture

• When standing patient reclines =

A

↓ 10% TC (total cholesterol), LDL, HDL

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17
Q

Position of the patient must be standardized for venipuncture

A

sitting position

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18
Q

Current NCEP guidelines for lipid concentration:____ minutes seated.

A

5mins

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19
Q

Prolonged venous occlusion = hemoconcentration (↑chole by____)

A

10-15%

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20
Q

Type of sample (plasma or serum)

• When applying Friedewald equation where____ is calculated -> Serum

A

LDL

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21
Q

Type of sample

_______: Ultracentrifugation & electrophoresis (LPP analysis)

A

Plasma

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22
Q

Type of sample

_____ should not remain in contact with the cells overnight

A

Plasma

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23
Q

Protein aggregation occurs less frequently using what sample?

A

Serum (less protein)

Plasma protein is about 3–5 g/liter greater than serum protein. (Taas protein sa plasma kay wala nag coagulate)

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24
Q

Type of sample (plasma or serum)

• Anticoagulant used:

_____: Large osmotic effects (Falsely low)

_____: Alter electrophoretic mobility

_____: preferred

A

Blue top (sodium citrate)

Green top (heparin)

Purple top (EDTA)

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25
Q

Storage

– TC, TAG, HDL, Apo

Long-term
Short-term

A

Long-term (>2 mos) -70C
Short-term (1-2 mos.) -20C

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26
Q

Estimation of Plasma Lipids

Cholesterol

A

A. Chemical Methods
a) Liebermann-Burchard
b) Salkowski
c) Abell-Kendall

B. Enzymatic methods

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27
Q

Cholesterol
A. Chemical Methods

A

a) Liebermann-Burchard
b) Salkowski
c) Abell-Kendall

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28
Q

2 mg of dry extract was dissolved in acetic anhydride, heated to boiling, cooled and then 1 ml of concentrated sulphuric acid was added along the sides of the test tube.

A

Liebermann-Burchard’s test

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29
Q

Liebermann-Burchard’s test:

Formation of______ colour indicates the presence of steroids.

A

GREEN

30
Q

2 mg of dry extract was shaken with chloroform, to the chloroform layer sulphuric acid was added slowly by the sides of test tube.

A

Salkowski reaction

31
Q

Salkowski reaction

Formation of ____ colour indicated the presence of steroids.

A

RED

32
Q

Formation of green colour indicates the presence of steroids.

A

Liebermann-Burchard’s test

33
Q

Formation of red colour indicated the presence of steroids.

A

Salkowski reaction

34
Q

Abell - Kendall

• Hydrolysis of CE using alcoholic KOH (potash) to UE form
• Extraction of UE form with petroleum ether
• Measurement with______ reagent

A

Liebermann-Burchard rgt.

35
Q

Liebermann-Burchard rgt.

A

Sulfuric acid, acetic acid, and acetic anhydride

36
Q

Abell - Kendall

Color indicator

A

BLUISH GREEN COLOR

37
Q

Yung gigawa during lab kay chemical or enzymatic method?

A

Enzymatic

38
Q

Benefits of enzymatic mtds:

A

• Smaller sample volume
• NO preliminary extraction step
• Rapid
• Precise

39
Q

Enzymatic method

_____ COLOR = READ AT____nm

A

RED

500nm

40
Q

Enzymatic method

Interfering Substances:

A

Plant sterols, Ascorbic acid, Bilirubin, Sample turbidity, Hgb

41
Q

+ H2SO4 =_____ END COLOR

A

PINK

42
Q

Quinoneimine dye

A

Faint Pink

43
Q

HDL-CHOLESTEROL MEASUREMENT

• Separated by chemical precipitation

Precipitating Agents

•– heparin in combination with manganese to precipitate apo B-containing LPP

•– sodium phosphotungstate with magnesium

•– Dextran sulfate with magnesium

•Interfering factor: elevated____ levels

•– assay for cholesterol content

A

Earliest

Alternative

More specific

TAG

Clear supernate

44
Q

HDL-CHOLESTEROL MEASUREMENT

• Gold standard / Reference Method

– 3-Step Procedure

A

– Ultracentrifugation – to remove VLDL

– Heparin Manganese Precipitation – to remove LDL

– Analysis of supernatant cholesterol by the AbellKendall Assay

45
Q

HDL-CHOLESTEROL MEASUREMENT

• Gold standard / Reference Method

– 3-Step Procedure

– – to remove VLDL

– – to remove LDL

– Analysis of supernatant cholesterol by the

A

Ultracentrifugation

Heparin Manganese Precipitation

AbellKendall Assay

46
Q

LDL-CHOLESTEROL MEASUREMENT

• Reference Method

•Electrophoretic migration

•Ultracentrifugation + Chemical Precipitation

A

Beta-Quantification

47
Q

LDL-CHOLESTEROL MEASUREMENT

Routine

A

Friedewald Calculation

48
Q

Estimation of Plasma Lipids FRIEDEWALD EQUATION/CALCULATION

mmol/L

A

LDL = TC – HDL – Plasma TAG/ 2.175 (mmol/L)

49
Q

Estimation of Plasma Lipids FRIEDEWALD EQUATION/CALCULATION

mg/dL

A

LDL = TC – HDL – Plasma TAG/5 (mg/dL)

50
Q

It is recommended that lipoprotein measurements be made no sooner than________ after any form of trauma or acute bacterial or viral infection, and_______ after childbirth.

A

8 weeks

3 to 4 months

51
Q

________ can be used when only cholesterol, TG, and HDL are measured

A

Plasma or serum

52
Q

In frozen samples =

A

TC, TAG, and HDL can be easily presereved

53
Q

Frozen samples are not appropriate for

A

ultra-centrifugal analysis

54
Q

continues to be the reference method for cholesterol used by the Centers for Disease Control and prevention or (CDC)

A

Abell-Kendel method

55
Q

Cholesterol measurement

This method can be accurate within about 0.5% of true value.

A

Enzymatic methods

56
Q

can be read photometrically at
500nm(Red Color)

A

Quinoneimine dye

57
Q

CHEMICAL METHODS FOR TAG

A

• Van Handel
• Zilversmit Method

58
Q

Measurement for TAG

Limits interfering substances

A

CDC - reference method

59
Q

TAG measurement

CDC - reference method
- Extraction of TAG by_____
- Isolation of TAG by_____
- Release of glycerol by____

A

chloroform

salicylic acid chromatography

saponification

60
Q

TAG Measurement

+ H2S04 =_____ END COLOR

A

PINK

61
Q

Triglycerides

(Enzyme)

Glycerol + Fatty acids

A

Lipase

62
Q

2H1,0, + Phenol +4-aminoantipyrine

(Enzyme)

Quinoneimine dye + 4H,O

A

Peroxidase

63
Q

ADP + Phosphoenol pyruvate

(Enzyme)

  • ATP + Pyruvate
A

Pyruvate kinase

64
Q

Pyruvate + NADH + H+

(Enzyme)

  • › Lactate + NAD*
A

Lactate dehydrogenase

65
Q

HDL-CHOLESTEROL MEASUREMENT

  • Precipitating Agents
    • Earliest -_______ in combination with_____ to precipitate apo B-containing LPP
A

heparin

manganese

66
Q

Precipitating agents

Alternative - _______with magnesium

A

sodium phosphotungstate

67
Q

Precipitating agents

More specific -______ with magnesium

A

Dextran sulfate

68
Q

HDL-CHOLESTEROL MEASUREMENT

Interfering factor:

A

elevated TAG levels

69
Q

HDL-CHOLESTEROL MEASUREMENT

  • assay for cholesterol content
A

Clear supernate

70
Q

Gold standard / Reference Method
- 3-Step Procedure
- Ultracentrifugation - to remove_____

  • Heparin Manganese Precipitation - to remove____
  • Analysis of supernatant cholesterol by the_______
A

VLDL

LDL

Abell-Kendall Assay