Lipids Flashcards

1
Q

What does every lipoprotein contain? (4)

A
  • Cholesterol
  • Triglyceride
  • Phospholipids
  • Apolipoproteins
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2
Q

What happens to ingested lipids? (4)

A
  • Internalized by small bowel enterocytes
  • Packaged into chylomicrons
  • Transported to hepatocytes
  • Endocytosed via apolipoprotein E
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3
Q

What happens to cholesterol and TG in the liver?

A

packaged into very low density lipoprotein (VLDL)

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4
Q

What is the function of VLDL?

A

vehicle for transport of cholesterol/TG into the bloodstream

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5
Q

In the blood, what happens to the TG in VLDL?

A
  • Undergoes progressive hydrolysis by endothelium bound lipoprotein lipase (LPL)
  • Produces IDL and LDL
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6
Q

What is the function of LDL?

A

-Main vehicle for transporting cholesterol from bloodstream to somatic cells.

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7
Q

What mediates endocytosis of LDL?

A

LDL receptor and Apolipoprotein B100

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8
Q

Where is HDL produced?

A

Liver

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9
Q

Lipoprotein classes - Protein (%)

  • Chylomicrons
  • VLDL
  • IDL
  • LDL
  • HDL
A
  • Chylomicrons - 1%
  • VLDL - 8%
  • IDL - 15%
  • LDL - 20%
  • HDL - 50%
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10
Q

Lipoprotein classes - Major Lipid

  • Chylomicrons
  • VLDL
  • IDL
  • LDL
  • HDL
A
  • Chylomicrons - TG
  • VLDL - TG
  • IDL - Cholesterol
  • LDL - Cholesterol
  • HDL - Cholesterol
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11
Q

Chylomicron apolipoproteins (4)

A
  • B-48
  • A-1
  • CII
  • E
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12
Q

VLDL apolipoproteins (3)

A
  • B-100
  • C
  • E
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13
Q

IDL apolipoproteins (2)

A
  • B-100

- E

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14
Q

LDL apolipoproteins (1)

A

-B-100

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15
Q

HDL apolipoproteins (3)

A
  • A-1
  • C
  • E
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16
Q

Which lipoproteins are measured?

-Calculated?

A
  • Total cholesterol
  • HDL
  • Triglycerides

*LDL is calculated

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17
Q

VLDL is often estimated as?

  • mg/dL
  • mmol/L
  • when is this estimation invalid?
A

VLDL is often estimated as:

  • TG/5 (mg/dL)
  • TG/2.2 (mmol/L)
  • Estimation NOT valid:
  • TG >400 mg/dL
  • Chylomicrons are present
18
Q

LDL is calculated using the Friedewald Equation:

A

LDL = Total cholesterol - HDL - (TG/5)

  • NOT valid:
  • TG >400 mg/dL
  • Chylomicrons are present
  • Cholestasis
19
Q

Lipoprotein electrophoresis migration:

  • chylomicrons
  • LDL
  • VLDL
  • HDL
A

Lipoprotein electrophoresis migration:

  • chylomicrons - do not move
  • LDL - Beta region
  • VLDL - preBeta region
  • HDL - alpha region
20
Q

Overnight refridgeration produces characteristic patterns in plasma:
-Excess chylomicrons

A

Creamy layer atop the plasma

21
Q

Overnight refridgeration produces characteristic patterns in plasma:
-Turbitity or opacity of the plasma

A

Abundant VLDL

22
Q

Overnight refridgeration produces characteristic patterns in plasma:
-LDL and HDL

A

Do NOT visibly alter the plasma

23
Q

What is the most notorious consequence of hyperlipidemia?

A

Premature atherosclerosis (particularly when cholesterol (LDL/IDL) is high

24
Q

What condition features Eruptive Xanthomas (crops of yellow, pruritic papulonodules)?

A

Hypertriglyceridemia

-Chylomicrons or VDLD

25
Q

Xanthelasma (yellow periorbital papules) are associated with what?

A

High Cholesterol (LDL)

26
Q

Elevated TGs (chylomicrons or VLDL) >500 mg/dL is associated with what?

A

Acute pancreatitis

27
Q

Classification of lipid disorders by predominant lipids - Familial LPL deficiency:

  • Phenotype
  • Cholesterol
  • TG
  • Features
A
Familial LPL deficiency:
-Phenotype - I
-Cholesterol - +
-TG - +++
Features:
-Eruptive xanthomas
-Pancreatitis
28
Q

Classification of lipid disorders by predominant lipids - Familial apoC-II deficiency:

  • Phenotype
  • Cholesterol
  • TG
  • Features
A

Familial apoC-II deficiency:

  • Phenotype - I or V
  • Cholesterol - +
  • TG - +++
  • Features - Pancreatitis
29
Q

Classification of lipid disorders by predominant lipids - Familial Hypercholesterolemia:

  • Phenotype
  • Cholesterol
  • TG
  • Features
A
Familial Hypercholesterolemia:
-Phenotype - IIa
-Cholesterol - +++
-TG - +
Features:
-Tendinous Xanthomas
-Premature Atherosclerosis
30
Q

Classification of lipid disorders by predominant lipids - Familial Dysbetalipoproteinemia:

  • Phenotype
  • Cholesterol
  • TG
A

Familial Dysbetalipoproteinemia:

  • Phenotype - III
  • Cholesterol - +++
  • TG - +++
31
Q

Classification of lipid disorders by predominant lipids - Familial Combined Hyperlipidemia:

  • Phenotype
  • Cholesterol
  • TG
  • Features
A

Familial Combined Hyperlipidemia:

  • Phenotype - IIb or IV
  • Cholesterol - ++
  • TG - ++
  • Feature - Premature Atherosclerosis
32
Q

Classification of lipid disorders by predominant lipids - Familial Hypertriglyceridemia:

  • Phenotype
  • Cholesterol
  • TG
  • Features
A
Familial Hypertriglyceridemia:
-Phenotype - IV or V
-Cholesterol - +
-TG - +++
Features:
-Eruptive Xanthomas
-Pancreatitis
33
Q

Predominant Hypercholesterolemia:

  • Plasma Total Cholesterol level
  • Lipoprotein
  • MC primary cause
A
  • > 200 mg/dL
  • LDL
  • Familial Hypercholesterolemia
34
Q

Familial Hypercholesterolemia:

  • Inheritance
  • Affect
A
  • Autosomal Dominant

- Deficiency of LDL receptors or LDL receptor activity

35
Q

Secondary causes of Predominant Hypercholesterolemia? (5)

A
  • Hypothyroidism
  • DM
  • Nephrotic syndrome
  • Cholestasis
  • Drugs (cyclosporine, thaizide/loop diuretics)
36
Q

Predominant hypertriglyceridemia is related to elevated?

A

Chylomicrons or VLDL

37
Q

An HDL level of what, is an independent risk factor for premature atherosclerosis?

A

<35 mg/dL

38
Q

Tangier Disease is an Autosomal Recessive disorder characterized by:

  • Cholesterol
  • TG
  • HDL
  • ApoA1
  • Manifestations
A

Tangier Disease:

  • Low Cholesterol
  • Normal to increased TGs
  • Absent HDL
  • Absent ApoA1
  • Cholesterol esters deposit in tonsils, LN, Vasculature, Spleen and corneal opacities
39
Q

The Third Adult Treatment Panel Report (APT III) major risk factors for coronary artery disease. (5)

A
  • Smoking
  • HTN
  • Low HDL
  • FHx of premature CAD
  • Age (M<45; W<55)
40
Q

ATP III Cholesterol classification - Total:

  • Desirable
  • High
A

<200 - Desirable

> 240 - High

41
Q

ATP III Cholesterol classification - LDL:

  • Optimal
  • Borderline
  • Very high
A

ATP III Cholesterol classification - LDL:

  • <100 - Optimal
  • 130-159 - Borderline
  • > 190 - Very high
42
Q

ATP III Cholesterol classification - HDL:

  • Low
  • High
A

<40 - Low

> 60 - High