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Clinical Chemistry > Lipids Exam 3 > Flashcards

Lipids Exam 3 Flashcards

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1
Q

Lipids are ____ in water but ____ in organic solvents

A

insoluble ; soluble

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2
Q

Triglycerides consist of

A

fatty acids + glycerol
major storage form

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3
Q

Phospholipids consist of

A

glycerol backbone
2 fatty acids + phosphoric acid group

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4
Q

Sterol characteristics

A

Cholesterol most important
serves as backbone for steroids
vitamin d - 2/3 esterified form

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5
Q

What is a lipoprotein made up of?

A

Triglycerides and cholesterol (mix of apoliproteins)

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6
Q

What is the main role of lipoproteins?

A

Delivery of fuel to peripheral cells; “core” being the cargo

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7
Q

What is the largest and least dense of all lipoprotein particles?

A

Chylomicrons

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8
Q

Chylomicrons are produced by

A

Intestine and packaged with absorbed dietary lipids.

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9
Q

The principle role of chylomicrons is

A

the delivery of dietary lipids into hepatic and peripheral cells

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10
Q

Chylomicrons transport _____ from the _____ to the _____

A

Triglycerides ; intestine ; adipose cells

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11
Q

Apoliprotein B-48 is associated with

A

Chylomicrons

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12
Q

Very low density lipoproteins (pre beta) are made up of

A

mostly triglycerides

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13
Q

Which lipoprotein is a major carrier of endogenous triglycerides into peripheral tissue during fasting for energy and storage?

A

Very low density lipoproteins

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14
Q

APO protein B-100 associated with

A

Very low density lipoproteins
Low density lipoproteins
Lipoprotein A

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15
Q

Which lipoprotein is found in patients with type 3 hyperlipoproteinemia?

A

Intermediate Density Lipoproteins

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16
Q

Hyperlipoproteinemia puts patients at risk for

A

peripheral vascular disease (PVD) and Coronary Artery disease (CAD), and damages vessel wall like LDL

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17
Q

LDL or Beta is made up of

A

Cholesterol, and principally carries it.

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18
Q

What lipoprotein was formed as a consequence of lipolysis of VLDL?

A

LDL

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19
Q

Where is LDL readily taken up?

A

via LDL receptor in liver and peripheral cells

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20
Q

What lipoproteins are better markers for CHD risk?

A

the 8 LDL subclasses that are separated by ultracentrifugation or electrophoresis

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21
Q

Elevated levels of this lipoprotein increase risk of premature CHD and Stroke

A

Lipoprotein A (>30 mg/dl)

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22
Q

Lipoprotein A competes with _____ for binding sites on endothelium and on fibrin, which promotes clotting (stroke)

A

Plasminogen

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23
Q

Who should get their Lipoprotein A measured?

A

Strong family history of CHD
Developed CHD on statin therapy
Premature Aortic stenosis (high lp(a) levels)

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24
Q

What lipoprotein is the smallest and most dense and removes cholesterol from cells and takes it to the liver for removal?

A

High density Lipoproteins (reverse cholesterol transport)

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25
Q

High density lipoproteins are synthesized by

A

Liver and intestine

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26
Q

Which lipoprotein can exist as disk-shaped or spherical particles?

A

High density lipoproteins

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27
Q

This lipoprotein is abnormal and present in biliary cirrhosis or choleostasis

A

Lipoprotein X

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28
Q

Lipoprotein X consists of

A

Phospholipids and nonesterfied cholesterol

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29
Q

In the exogenous pathway, what enzyme converts dietary lipids into polar compounds making them amphipathic?

A

Lipase

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30
Q

Which Hydrolytic enzymes from the pancreas process lipids?

A

Lipase (breaks down triglycerides)
Cholesterol esterase (releases free cholesterol)
Phospholipase A (hydrolyzes phospholipids)

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31
Q

What is lipoprotein Lipase’s role in the exogenous pathway?

A

clears chylomicrons and breaks down triglycerides

32
Q

Triglycerides are converted to

A

fatty acids by cells and ready to be used for energy

33
Q

Excreted biliary cholesterol appears in

A

stool (fecal neutral steroids)

34
Q

Triglycerides that are packaged into VLDL in the endogenous pathway are split into? by which enzyme?

A

They are split in IDL’s and VLDL remnants ; lipoprotein lipase

35
Q

Cleaved IDL’s have two fates in the endogenous pathway:

A

They could either receive cholesterol esters from HDL in exchange for triglycerides, or be made into LDL in the liver by removing triglycerides

36
Q

VLDL remnants have two fates in the endogenous pathway:

A

They could either be taken up in the liver, or be made in to LDL which delivers cholesterol to peripheral cells because of the LDL receptors.

37
Q

Triglycerides inside the cell in the endogenous pathway are converted to

A

Free fatty acids and glycerol by the cell for energy

38
Q

What enzyme transports excess cholesterol from the cell?

A

Lecithin cholesterol acyltransferase

39
Q

What is HDL’s role in the endogenous pathway?

A

takes cholesterol back to the liver for disposal in bile salts

40
Q

What happens if cells are full in the endogenous pathway?

A

LDL forms plaques

41
Q

LDL receptors regulate

A

Cellular cholesterol biosynthesis and degradation

42
Q

Hypercholesterolemia and premature atherosclerosis are abnormalities in

A

LDL receptor regulation

43
Q

What enzyme converts cholesterol into Cholestryl ester (HDL3) in the aqueous diffusion pathway?

A

LCAT enzyme

44
Q

HDL2 delivers cholesterol to

A

Liver

45
Q

What is the end product of the aqueous diffusion pathway?

A

Cholesterol in liver directly excreted into bile or converted to bile acid.

46
Q

The ABCA1 transporter is

A

A member or ATP binding cassette transporter family

47
Q

The principle function of the ABCA1 transporter is to

A

enable APO A-1 from HDL to bind to cell membrane and in a detergent like mechanism, remove excess cholesterol and phospholipid from cells

48
Q

HDL forms what shape to accept additional cholesterol?

A

discoid shape

49
Q

What enzyme converts discoid shape HDL to spherical HDL?

A

LCAT

50
Q

Cell based assay tests the

A

capacity of cholesterol loaded macrophages to efflux cholesterol through ABCA1 transporter

51
Q

What assay provides additional knowledge of HDL function?

A

Cell-based assay

52
Q

The cell based assay is found to be inversely corelated with

A

intima media thickness and with presence of CHD (disease status)

53
Q

Low levels of cell based assay can be associated with

A

atherosclerotic cardiovascular disease

54
Q

The analysis of lipids includes

A

total amount of all lipoproteins

55
Q

What reagent is used for the colorimetric method of cholesterol and what is the name of the method?

A

Abell Kendall method
Liebermann buchard color reagent
Acetic acid, acetic anhydride and sulfuric acid produce green color

56
Q

What is the reference method for cholesterol?

A

Gas chromatography mass spectrophotometry, not related sterols, cholesterol only.

57
Q

What interferes with the Colorimetric- Abell Kendal method?

A

Hemoglobin, bilirubin, water (causes cloudiness)

58
Q

What can cause increase in cholesterol values?

A

An increased cholesterol level can indicate an increased risk of CHD
may be caused by diabetes, estrogen, hypothyroidism

59
Q

What are the pre analytical factors that influence values of cholesterol?

A

Stress, diurnal variation, higher in the winter

60
Q

in post mortem specimens, why is blanking necessary for triglycerides?

A

triglycerides rapidly convert to glycerol after death

61
Q

Within triglyceride methods, what is measured?

A

Include the hydrolysis of triglyceride to form glycerol and fatty acids; measures glycerol

62
Q

In the enzymatic method for triglycerides, what two enzymes are coupled together and what do they produce?

A

Glycerol kinase and Glycerophosphate oxidase coupled to same peroxidase color reaction used in cholesterol

63
Q

What does alkaline hydrolysis form in the colorimetric method in triglycerides?

A

Glycerol

64
Q

What does glycerol oxidize to in the colorimetric method in triglycerides?

A

Formaldehyde and formic acid

65
Q

What is the color development in the van handel and zilversmith reaction in triglyceride colorimetric method?

A

Formaldehyde and chromotropic acid will form pink color

66
Q

What is the reaction in Hantzch condensation in triglyceride colorimetric method?

A

Formaldehyde, ammonium ion, and acetyl acetone will form diacetyl lutidine

67
Q

What condition increases as HDLc decreases?

A

Coronary heart disease

68
Q

How is HDL analyzed?

A

selective precipitation, divalent cations in solution of buffer, heparin, or dextran sulfate. Will precipitate VLDL and LDL leaving HDL.

69
Q

What increases HDL Levels?

A

Weight reduction
Jogging
Estrogen
Alcohol

70
Q

What could interfere with calculating LDL

A

presence of chylomicrons

71
Q

What LDL sub particle is smaller and denser, more responsive to statin drugs and niacin, and imposes a risk of CHD?

A

Pattern B

72
Q

What LDL sub particle is larger and less dense, and is more responsive to fibrates or niacin. And lowers triglyceride, but has side effects of flushing?

A

Pattern A

73
Q

What drugs can be used to manage lipid levels?

A

Statins and Repatha

74
Q

What is the primary prevention for those at risk of CVD?

A

Statins, Atorvastin, Fluvrastatin.

75
Q

Statins are

A

HMG- COA reductase inhibitors, they are lipid lowering medication by decreasing LDLc.

76
Q

What are the side effects of statins?

A

Myalgia, rhabdomyolysis, liver damage

77
Q

Repatha can be defined as

A

monthly injections to decrease LDLc, it is beneficial for those with myalgia from statins.

Clinical Chemistry (10 decks)

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