Lipids

Question 1

What part of a cell does cholesterol make up?

Answer 1

The cell membrane

Question 2

What other roles does cholesterol play in the body

Answer 2

• Structural

- Functional

Question 3

The build up of cholesterol can lead to what in the body?

Answer 3

Atherosclerosis- and impede blood flow

Question 4

Where are cholesterol and fat located in the body?

Answer 4

The circulate in the blood

Question 5

Can cholesterol and fat dissolve in water?

Answer 5

Nope

Question 6

Since they circulate in the blood (that is mostly water) they are carried on protein packages known as…

Answer 6

Apoproteins

Question 7

Apoprotein + lipid =

Answer 7

Lipoprotein

Question 8

What is the main type of lipoprotein?

Answer 8

LDL

Question 9

How much apoprotein and cholesterol does LDL have?

Answer 9

Apoprotein= 25%
Cholesterol= 45%
-Bad cholesterol

Question 10

How much apoprotein and cholesterol does HDL have?

Answer 10

Apoprotein= 50%
Cholesterol= 20%
-Good cholesterol

Question 11

Describe LDL

Answer 11

-Provides cholesterol that is necessary for body functions but excessive amounts promote accumulation in the artery walls (atherosclerosis)

Question 12

What is the role of HDL?

Answer 12

Remove excess cholesterol from the blood

Question 13

What is the desirable ratio of LDL to HDL?

Answer 13

Low LDL to high HDL

Question 14

What is VLDL?

Answer 14

-Precursor to LDL

Question 15

Where is VLDL made?

Answer 15

In the liver, and it contains a high triglyceride component

Question 16

What is the injury theory for high cholesterol and heart disease?

Answer 16

• A thin layer of cells that lines the arteries are damaged
• High cholesterol hinder the repair process and instead of platelets plugging the damage, the stickiness of the plaque covers the damage and allows other plaque to stick on their too

Question 17

A plaque forms when…

Answer 17

More cholesterol sticks to the site of injury- this makes the lumen thinner and thinner
-leads to impaired blood flow

Question 18

What is cholesterol needed for?

Answer 18

• Nerve tissues
• Brain tissue
• Skin
• Adrenal glands
• Liver

Question 19

Cholesterol is the main component in ____ and ________

Answer 19

Bile and sex hormones

Question 20

What much cholesterol does the liver produce daily?

Answer 20

1000 mg daily

Question 21

What are the 2 major etiologies for high cholesterol?

Answer 21

• Overproduction by the body (rare)

- Excessive intake from the diet

Question 22

What are risk factors for coronary artery disease

Answer 22

-Cigarette smoking
-Hypertension
-Low HDL
-High LDL
-Age
-Diabetes
-Sedentary life style
-Obesity
(most factors are modifiable)

Question 23

Should lipid testing be done after acute tissue injury?

Answer 23

No- lipids are FALSELY LOW after acute tissue injury

Question 24

What is pregnancies effect on lipid levels?

Answer 24

Increase in lipid concentration (don’t test during pregnancy or 9 months after pregnancy)

Question 25

Prepubertal children may have _________ lipid levels

Answer 25

FALSELY HIGH

Question 26

Should lipid testing be fasting/non-fasting

Answer 26

Fasting for 9-12 hours

Question 27

What is the risk for atherosclerosis based on?

Answer 27

- Lipid profile | - Risk factors for CAD

Question 28

What is the primary target of cholesterol therapy?

Answer 28

LDL levels

Question 29

What is an optimal LDL level

Answer 29

LDL less than 100

Question 30

What is the optimal total cholesterol?

Answer 30

Total cholesterol is less than 200

Question 31

What is the optimal HDL levels?

Answer 31

Over 60, women should be over 45 (at least) | -The more HDL the better

Question 32

What do triglyceride levels reflect?

Answer 32

The fat in your diet

Question 33

What are normal triglyceride levels?

Answer 33

Triglycerides less than 150

Question 34

What are the guidelines for cholesterol if the patient has co-morbidities?

Answer 34

More strict... - LDL less than 100 w/ one, or less than 70 w/ 2 or more - Total cholesterol less than 150 - HDL greater than 60

Question 35

How is hypercholesterolemia treated?

Answer 35

Lifestyle changes= exercising, diet, weight management | -Statins for medications

Question 36

How can HDL be increased?

Answer 36

- Exercise - Medication - Stop smoking

Question 37

How can elevated trigylcerides be treated?

Answer 37

- Very low fat diets - Medication - Strict control of co-morbidities

Question 38

When are men and women screened for cholesterol levels?

Answer 38

Men- over 35 | Women- over 45

Question 39

When are men and women screened for cholesterol if they have CHD risk factors

Answer 39

``` Men= anytime over 20 Women= between 20 and 45 ```

Question 40

Can hypercholesterolemia be familial?

Answer 40

Yes- an inherited defect in LDL receptors that leads to INCREASED production of cholesterol and premature atherosclerosis (these patients usually have an MI by 30 or 40

Question 41

Can hyperbetalipoproteinemia be familial?

Answer 41

- Yes- caused by an abnormality or change in the LDL receptor structure - Cholesterol concentrations are usually around 300-400 - Premature atherosclerosis usually presents around 40 or 50 years old

Question 42

Can hyperalphalipoproteinemia be familial?

Answer 42

- Yes- autosomal dominant trait associated with increase in HDL - VERY GOOD THING - LDL is normally normal - Total is usually high (because HDL is high) - Patients usually live well into their 90s

Question 43

What is secondary hypercholesterolemia

Answer 43

-A variety of disorders that increase lipoprotein synthesis (nephrotic syndrome, obstructive jaundice, hypothyroidism) -Total cholesterol can be 600-800 or higher