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Adv. Clinical Chem
Exam 1- Lipids
| Question | Answer |
|---|---|
| WHAT ARE THE PLASMA LIPOPROTEIN CLASSES IN ORDER BY LOWEST DENSITY TO HIGHEST DENSITY? | CHYLOMICRONS, VLDL, LDL, AND HDL |
| NAME THE MAJOR APOLIPOPROTEINS FOR EACH LIPOPROTEIN CLASS. | CHYLOMICRON: A,B,C VLDL: B,C,E LDL: B HDL: A |
| WHAT ARE THE PREDISPOSING CORONARY HEART DISEASE RISK FACTORS? | Overweight and obesity Physical inactivity Male sex Family history Socioeconomic factors Behavioral factors Insulin resistance |
| WHAT IS THE FUNCTION OF HDL? | TAKES CHOLESTEROL FROM TISSUES TO THE LIVER VIA THE BLOODSTREAM. |
| WHAT IS THE FUNCTION OF LDL? | TAKES CHOLESTEROL TO THE TISSUES. |
| WHAT LIPOPROTEINS MAKE UP THE TRIGLYCERIDES? | CHYLOMICRONS AND VLDL |
| WHAT IS THE CAUSE OF FAMILIAL HYPERCHOLESTEROLEMIA AND WHAT IS THE PREVALENCE? | GENETIC DEFECTS IN THE LDL RECEPTOR PROTEIN THAT PREVENTS BINDING AND UPTAKE OF LDL BY THE CELL CAUSING HIGH LEVELS OF LDL AND INCREASED CHD RISK. ~1/500 |
| WHAT IS METABOLIC SYNDROME ALSO KNOW AS? | INSULIN RESISTANCE SYNDROME (IRS) SYNDROME X |
| HAVING 3+ OF THE FOLLOWING MEANS YOU HAVE WHAT? 1. Abdominal obesity: >40”waist-men,>35” waist-women 2. High trigS:≥150 mg/dL 3. Low HDL:<40mg/dL men;<50mg/dL women 4. High BP: Systolic≥ 130 or Diastolic ≥ 85 5. High fasting plasma glucose: ≥ 100mg/d | METABOLIC SYNDROME |
| WHAT ARE THE DESIRABLE CUTOFFS FOR TOTAL CHOLESTEROL, TRIG, LDL, AND HDL? | TOTAL CHOLESTEROL <200MG/DL TRIG <150MG/DL LDL <100MG/DL HDL >45MG/DL |
| WHAT ARE THE HIGH RISK CUTOFFS FOR TOTAL CHOLESTEROL, TRIG, LDL, AND HDL? | TOTAL CHOLESTEROL > OR =240MG/DL TRIG >200MG/DL LDL >160MG/DL HDL <40MG/DL |
| WHAT TREATMENT IS SUGGESTED FOR ELEVATED TRIG LEVELS? | LOWER LDL, INTENSIFY WEIGHT MANAGEMENT, INCREASE PHYSICAL ACTIVITY, INCREASE HDL |
| HOW MUCH LIFETIME RISK OF CORONARY HEART DISEASE CAN BE REDUCED WITH 1% REDUCTION OF LDL? | 2% RISK REDUCTION |
| IN THE ENZYMATIC CHOLESTEROL ASSAY, WHAT ENZYME IS USED TO SEPARATE CHOLESTEROL FROM CHOLESTEROL ESTER? | CHOLESTEROL ESTERASE |
| IN THE ENZYMATIC TRIGLYCERIDE ASSAY, LIPASE SEPARATES TRIGLYCERIDE INTO TWO COMPONENTS. WHAT ARE THEY AND WHICH ONE IS THE COMPONENT OF INTEREST? | GLYCEROL AND FATTY ACIDS. GLYCEROL IS THE COMPONENT OF INTEREST MEASURED WITH A RED CHROMAGEN AT 510NM. |
| LIPOPROTEINS CAN BE SEPARATED USING WHICH METHODS? | ULTRAFILTRATION, ELECTROPHORESIS, PRECIPITATION-HDL, HOMOGENEOUS METHODS (EMIT) |
| WHAT DOES THE FRIEDWALD EQUATION CALCULATE? GIVE THE FRIEDWALD EQUATION. | IT CALCULATES LDL. LDL = TOTAL CHOL - HDL - (TRIG/5) ONLY VALID IF TRIG < 400MG/DL |
| HOW CAN LIPOPROTEINS BE DIRECTLY MEASURED? | REMOVE UNWANTED LIPOPROTEINS USING PRECIPITATION OR RAISE POLYCLONAL ANTIBODIES TO THE UNWANTED FRACTIONS. SEPARATE THE FRACTIONS AND MEASURE THE ELUATE/SUPERNATANTS. |
| WHAT ARE THE SPECIMEN REQUIREMENTS FOR LIPID ASSAYS? | FASTING SPECIMEN, EDTA AND HEPARIN TUBES, PATIENT SHOULD BE SEATED FOR 15 MINS TO REDUCE HEMOCONCENTRATION AND INCREASED LIPIDS, TOURNIQUET FOR < 1 MIN TO AVOID HEMOCONCENTRATION. |
| INTERFERENCES IN LIPID ASSAY MEASUREMENTS CAN BE CAUSED BY WHAT 3 THINGS IN THE SPECIMEN? | LIPEMIA BILIRUBIN HEMOLYSIS |
| WHAT ARE THE CONDITIONAL RISK FACTORS FOR CHD? | HIGH HOMOCYSTEINE, HIGH FIBRINOGEN, PRESENCE OF LIPOPROTEIN(a), hsCRP |
| IF HOMOCYSTEINE LEVELS ARE HIGH, WHAT SUPPLEMENTS/DIETARY INTAKE CAN BE USED TO DECREASE HOMOCYSTEINE AND CHD RISK? | VITAMIN B6, B12, FOLIC ACID |
| HOMOCYSTEINEMIA IS CAUSED BY THE LACK OF WHAT ENZYME TO METABOLIZE HOMOCYSTEINE? | CYSTATHIONINE B-SYNTHASE |
| WHAT FORMS WHEN THERE ARE HIGH LEVELS OF OXIDIZED LDL? | FOAM CELLS WHICH WILL NARROW THE BLOOD VESSELS. |
| HOW DO YOU CONVERT CHOLESTEROL VALUES FROM MG/DL TO MMOL/L? | divide the mg/dl value by 38.7 |