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Lipids and Dyslipoproteinemia

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Question
Answer
Cholesterol travels in circulation in spherical particles containing both lipids and proteins. These particles are called?   lipoproteins  
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what are the three main classes of lipoproteins measured in the serum   VLDL, LDL, HDL  
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VLDL are composed mostly of?   triglycerides  
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what is the main atherogenic class of lipoproteins   LDL  
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How does HDL affect ones risk for development of atherosclerosis   inversely  
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what is the optimal level for LDL   <100 (100-129 is near optimal/above optimal) and (130-159 is borderline high)  
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what level of LDL is high   >160 ( > 190 is very high)  
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what level of Total cholesterol is desirable   <200 (200-239 is borderline high)  
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what level of total cholesterol is high   >240  
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what level of HDL is desireable   >40 (<40 is low and >60 is high)  
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what are the 5 modifiable CHD risk factors   1) Smoking 2)Hypertension 3) Low HDL 4) Family Hx 5) Age  
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oxidation of LDL has been shown to increase atherogenesis how can that be inhibited   anti-oxidants  
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what is the only gentically determined component of lipoproteins   apolipoproteins  
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what is the major protein component of HDL particles   Apolipoprotein A1  
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what is the major protein component of LDl   Apolipoprotein B100  
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how does Lp(a) affect thrombosis   Lp(a) can compete for the binding of plasminogen to its cell membrane receptor on the endothelial surface  
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how does homocysteine enhance the atherosclerotic process   Generation of superoxide and hydrogen peroxide, enhanced coagulation, inhibiting dilation of small arteries, promoting smooth muscle proliferation  
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what happens when Homocystein and LDL interact   they form LDL-homocysteine thiolactone aggregates which are taken up by macrophages and subsequently incorporated into foam cells in early atherosclerotic plaques  
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how can you lower serum concentrations of homocysteine   treatment with daily supplements of folic acid, vitamins B6 and B12  
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what is a better predictor of cardiovascular events fasting or non-fasting triglycerides   non-fasting triglycerides  
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how are foam cells formed from LDL   Ox-LDL is taken up in macrophage scavenger receptors, promoting cholesterol ester accumulation and foam cell formation  
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How is percentage error related to bias and CV as per NCEP guidelines   % total error = %bias + 1.96 * (%CV)  
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What is the % total error acceptability limit for Total Cholesterol   <=9%  
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What is the % total error acceptability limit for Triglycerides   <=15%  
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What is the % total error acceptability limit for HDL Cholesterol   <=13%  
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What is the % total error acceptability limit for LDL Cholesterol   <=12%  
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What is the % total error for Cholesterol in a laboratory with a bias of 3.5% and a CV of 2%    
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For evaluation of elevated cholesterol levels, diabetic patients are treated like patients who already have CHD. Diabetes confers a high risk of new CHD within how many years?   10 years  
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ATP III (3rd report of NCEP 2002) , recognized for evaluation of elevated cholesterol levels which two conditions as candidates for intensive intervention and therapy   Metabolic Syndrome and patients with a high 10 year risk for CHD based on the Framingham risk projections  
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Is the focus of NCSP guidelines on recognizing abnormal and normal cholesterol values   No, it is shifted to assessing overall cardiovascular risk based on cutoffs for cholesterol, triglycerides, HDL-C and LDL-C  
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What are the tests recommended by ATP III as initial test for evaluating blood cholesterol   Complete lipoprotein profile - TC, LDL-C, HDL-C and Triglycerides  
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how often should a fasting lipoprotein profile be obtained   in adults over 20 it should be obtained every 5 years  
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In a patient that is non-fasting what parts of the fasting lipoprotein profile will be usable   the Total Cholesterol and HDL will be usable (get follow-up if TC is >200 or HDL is <40)  
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What is the primary target for Cholesterol lowering therapy   LDL-C  
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what is the LDL goal if you have CHD or CHD risk equivalents   <100  
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what is the LDL goal if you have 2+ risk factors   <130  
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what is the LDL goal if you have 0-1 risk factors   <160  
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What are the two approaches used to reach LDL-C goal   Therapeutic lifestyle change (TLC) and drug therapy  
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What are components of Therapeutic Lifestyle change   Dietary change and increased physical activity, combined with regular follow-up - this represents 1st line of therapy (may be combined initially with drug therapy in high risk patients)  
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What are the drugs used for hyperlipidemia   Statins, fibric acid derivatives, bile acid resins, and nicotinic acid  
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