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CV > Lipids > Flashcards

Lipids Flashcards

1
Q

chylomicrons

A
  • lowest density lipoproteins
  • 90-96% TG
  • Apo B-48, E, C-11
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2
Q

VLDL

A
  • still very low density
  • 60% TG
  • Apo B-100, E, C-11
  • TG is surrogate for # of VLDL particles
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3
Q

LDL

A
  • Primary atherogenic class in body-primary determinant of risk
  • more dense
  • predominant for cholesterol (50%)
  • Apo B-100
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4
Q

HDL

A
  • smallest, most dense
  • mostly protein and cholesterol
  • Apo A-1 and A-11
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5
Q

Apo-C

A

activates lipoprotein lipase

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6
Q

Apo-E

A

remnant receptor ligand

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7
Q

Apo-B 100

A

From liver

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8
Q

Apo-B48

A

from intestine

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9
Q

Statins

A
  • HMGCoA Reductase inhibitor
  • Major effect-lower LDL-C 20-60%; modestly lower TG and increase HDL-C
  • pleotropic effects-inhibition of isoprenylation of small GTP-binding proteins
  • SE: myalgia, myopathy, abnormal liver fxn tests
  • Pregnancy class X
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10
Q

Statin mechanism

A
  • Inhibit HMGCoA reductase-> necessary for synthesizing cholesterol
  • reduce intrahepatic cholesterol pool-> increase hepatic LDL receptors and remove LDL from bloodstream
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11
Q

Bile Acid binding Resins

A
  • decrease LDL-C 15-30%, modest increase in TG and HDL-C
  • Block absorption of bile salts in terminal ileum-> decreases intrahepatic pool and increases receptor
  • May produce compensatory increase in HMGCoA R-best w/ statin
  • SE: abdominal discomfort and constipation, decrease absorption of other drugs, decrease absorption of fat soluble vitamins
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12
Q

Azetidinones

A
  • Decrease LDL-C by 14-20%, small decrease in TG, small increase in HDL-C
  • blocks absorption of cholesterol in small intestine by inhibiting NPC1L1 protein->decrease intrahepatic pool
  • well tolerated
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13
Q

Apo A1

A

combines w/ free cholesterol to make nascent HDL

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14
Q

LCAT

A

esterifies cholesterol to make mature HDL

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15
Q

SR-B1 receptor

A

mature HDL receptor in liver

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16
Q

CETP

A
  • cholesterol ester transfer protein
  • acts when TG levels high
  • transfers TG into HDL and cholesterol esters into CM/VLDL/LDL
17
Q

arcus corneus

A
  • gray stripe on outer iris

- signifies high TG, low HDL

18
Q

xanthelasmas

A
  • seen in familial hypercholesteremia

- cholesterol deposits on eyelid

19
Q

eruptive xanthoma

A
  • in chylomicronemia syndrome
  • looks like chicken pox on butt
  • seen on surfaces that rub against things
  • fat eruptions through skin
20
Q

lipemia retinalis

A
  • fat globules inside vessels (streaks(

- in chylomicronemia syndrome

21
Q

Familial hypercholesterolemia

A
  • genetically deficient/defective LDL receptor
  • autosomal dominant
  • tendon xanthoma, xanthelasmas, arcus corneus
  • heterozygotes-cardiac events- men 20s, women 30s
22
Q

Familial defective Apo B-100

A
  • mutation in gene for ApoB-100 leads to poor LDL binding to receptors
  • functionally similar to FH
  • LDL easily oxidized
23
Q

Familial Combined Hyperlipidemia

A
  • varying patterns of LDL-C and VLDL-C in families
  • high levels of ApoB-100 lead to to high levels of VLDL and LDL (hyperapobetalipoproteinemia); 1/3 also have LPL abnormality
  • xanthelasmas, arcus corneus, HTN, DM II, obesity
24
Q

Familial hypo alpha lipoproteinemia

A
  • autosomal dominant defects in ABC A1
  • low HDL
  • cataracts, arcus corneus
  • increased risk of CHD
25
Q

Niacin

A
  • nicotinic acid, vitamin B3
  • mechanism: reduce lipolysis from adipocytes; reduce VLDL synthesis by inhibiting DGAT2; reduce ApoA-1 catabolism
  • SE: flushing and itching (tx-aspirin), abdominal pain, ulcers, insulin resistance, hyperglycemia, hepatotoxicity, gout, myalgia/myopathy
  • do not use if pregnant
26
Q

Fibrates

A
  • mechanism: activates PPAR-a-> increase synthesis of ApoA- I and II; activates LPL and decrease ApoCIII (LPL inhibitor); stimulates hepatic FA uptake and catabolism by B-oxidation-> decrease TG synthesis
  • SE/precautions: abdomial pain, gall stones, increase creatinine-DNU kidney ds, myalgia/myopathy, liver ds, pregnancy
27
Q

Omega 3 FAs

A
  • reduce TG, increase HDL, LDL may increase or stay
  • mechanism: inhibit DGAT, reduce lipolysis, stimulate hepatic FA catabolism by B-oxidation-> decrease TG synthesis
  • SE: eructation, flatulence, abdominal pain, bruising/bleeding

CV (4 decks)

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