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CP2 Lipids pt 1

Basic Lipid Questions

QuestionAnswer
Are lipids soluble or insoluble in water and most biological fluids? Insoluble
What are lipids dependent upon in order be transported? Protein incorporated into the molecule or binding to plasma protein.
What are lipids found to be present in combination with in physiologic fluids? Proteins
What are lipoproteins composed of? Lipids and proteins in varying proportions.
What are 3 functions of Lipids? (5 listed) 1.Structural and functional elements of biomembranes 2. precursors to other essential substances 3.sources of biochemical fuel 4.energy storage depots 5.insulators
What are the 4 classes of lipoproteins? Chylomicrons HDL LDL VLDL
What is a Lipoprotein level an accurate predictor of? CHD
What is the main purpose of lipoproteins in the blood? transport cholesterol, triglycerides, and other insoluble fats.
What is the major component of chylomicrons? triglycerides
What is the major component of LDLs? cholesterol
What is the major component of VLDLs? triglycerides
What is the major component of HDLs? protein
How long does it take for chylomicrons to clear the bloodstream? 12 hours
Where do chylomicrons originate from? the intestinal epithelial cells
Where do chylomicrons tend to carry triglycerides? adipose cells for storage working cells for catabolism
What structure clears chylomicrons from the blood? How? Liver incorporates the triglycerides into lipoproteins and releases them back to the blood as VLDL
Describe the main function of HDL. What is this function called? carry cholesterol in the bloodstream from the tissues to the liver Reverse cholesterol transport
What is the suspected mechanism as to how HDLs have a protective effect for the body? They may prevent cellular uptake of cholesterol and lipids
What should the HDL/TC ratio be? Ideal ratio? at least 1:5 with 1:3 being ideal 1:4.5 for premenopausal women
Are HDL levels directly proportional or inversely proportional to risk of CHD? inversely
HDLs are composed of _______% protein 50
What is the absolute bottom level of HDL for men? women? >40 mg/dL men >46 mg/dL women
What level of HDL is considered protective against HD? >60 mg/dL
What are the 4 ways in which HDLs would be elevated? Hyperalphalipoproteinemia regular physical activity weight loss chronic liver disease
What are 2 ways that HDL levels would be decreased? (15 listed) 1 of 2 1. uncontrolled diabetes 2. hepatocellular disease 3. chronic renal failure 4. nephrosis 5. cholestasis 6. abetalipoproteinemia 7. familial hyper-a-lipoproteinemia 8. deficiency of apo A-I and apo C-III
What are 2 ways that HDL levels would be decreased? (15 listed) 2 of 2 1. cigarette smoking 2. obesity 3. lack of exercise 4. androgenic and related steroids 5. B-androgenic blocking agents 6. hypertriglyceridemia 7. genetic factors
What are 3 limiting ways that HDLs become increased? moderate alcohol consumption estrogen insulin
What are 3 limiting ways that HDLs become decreased? starvation, stress, recent illness, smoking, obesity, lack of exercise, steroids, thiazide diuretics, beta blockers, hypertriglyceridemia, and elevated serum immunoglobulin levels
Are HDL levels age and sex dependent? Yes
Following what event do HDL values significantly decrease for as long as 3 months? Myocardial Infarction
If a patient is hypothyroid what happens to their HDL levels? hyperthyroid? hypo-elevated hyper-diminished
Low density lipoproteins are ___________ rich. Cholesterol
Cholesterol carried by LDLs can be deposited into the _________ tissues. This is associated with an increased risk of ______________ and _____________. Peripheral arteriosclerotic heart and peripheral vascular disease
LDL levels are ____________ related with CHD. directly
LDLs are composed of _______% cholesterol. 45
What is the low value for LDL? <130 mg/dL
What is considered very high for LDL levels? >/= 190 mg/dL
What is considered an optimal value for LDL levels? <100 mg/dL
What are a few ways in which LDL levels can be increased? (6 listed) 1. Familial hypercholesterolemia 2. Nephrotic syndrome 3. Hepatic disease 4. Hepatic obstruction 5. Chronic renal failure 6. Hyperlipidemia types II and IIIDM
What are a few ways in which LDL levels can be decreased? (8 listed) 1. Abetalipoproteinemia 2. Hyperthyroidism 3.Tangier disease 4.Hypolipoproteinemia 5. Chronic anemia 6. Lecithin cholesterol acyltransferase deficiency 7. Apo C-II deficiency 8. Hyperlipidemia type I
Eating what increases serum cholesterol? Saturated fat Cholesterol as well, if you have trouble metabolizing it
What blood pressure level may contribute to an increase of cholesterol? 140/90 mm/Hg (hypertension)
What level of Non-HDL cholesterol is preferred in reference to LDL-C? about 30 mg/dL higher than LDL-C
What are the recommended levels for non-HDL-C for... Prevention of CHD? Regression of CHD? no more than 120 mg/dL no more than 100 mg/dL
What are a few recommendations for not reporting calculated LDL-C? nonfasting triglycerides over 400 (inaccuracies over 200) type III hyperlipoproteinemia
Approximately what percent of apoB particles are LDL particles? Why? 90% it is believed that they have a longer half life compared to VLDL particles
Why is it that LDL particles are believed to be more of a determinant of cardiovascular risk than VLDL particles? because of their smaller size and greater length of time in circulation.
What is cholesterol a precursor to? Bile acids, progesterone, Vit D, estrogens, glucocorticoids, and mineralcorticoids.
What are the two sources of cholesterol? de novo synthesis diet
how much cholesterol can the liver produce in a day? what about all other tissues combined? 1.5 g/day .5 g/day
how much more cholesterol is biosynthesized from acetate in comparison to what is consumed? 2-3 times
What is the main lipid associated with arteriosclerotic vascular disease? Cholesterol
What percentage of cholesterol is bound to LDLs? HDLs? 75% 25%
subnormal levels of cholesterol is indicative of what? name another major issue associated with low cholesterol levels. severe liver disease malnutrition
how large of a percent difference is there for a within-individual TC measurement? 6%
until what ages (males and females separately) do cholesterol levels gradually increase and then plateau? males-50 females-70
Is cholesterol by itself an accurate predictor of heart disease? no
Is there overlap of what is considered normal and high risk levels for heart disease? why? yes, due to significant variables.
should elevated levels on a lipid panel be considered for a study repeat? yes average the two results to obtain an accurate risk assessment
does pregnancy interfere with cholesterol levels? yes, by increasing
what are 3 drugs that can increase cholesterol levels? adrenocorticotropic hormone, anabolic steroids, beta-adrenergic blocking agents, corticosteroids, epinepherine, oral contraceptives, phenytoin, sulfonamides, thiazide diuretics, and vit D
what are 3 drugs that can decrease cholesterol levels? allourinol, androgens,bile salt binding agents, captopril, chlorpropamide, clofibrate, colchicine, colestipol, erythromycin, isoniazid, liothyrinone, lovastatin, monoamine oxidase inhibitors, neomycin, niacin, and nitrates
What are normal/desirable values for cholesterol in adults? 125-200 mg/dL
What are normal/desirable values for cholesterol in children? 120-200 mg/dL
What are normal/desirable values for cholesterol in infants? 70-175 mg/dL
What are normal/desirable values for cholesterol in newborns? 53-135 mg/dL
Would you use a fasting or non-fasting sample for total cholesterol? Either are adequate
how long prior to a lipoprotein profile being drawn should the patient stop consuming alcohol? 24 hours
What are the 4 possible issues that could cause a person to have a total level of <90 mg/dL cholesterol? 1. Liver disease 2. Anemia 3. Hypertension 4. malnutrition/vegan
What is a desirable level for total cholesterol? <200 mg/dL
What is considered a high risk level for total cholesterol? >240 mg/dL
What is considered an Acutely high level of total cholesterol? 400 mg/dL
What is considered a Chronically high level of total cholesterol? 700-800 mg/dL
How is cholesterol removed from the body? Through Bile Acids
Name 5 main ways in which total cholesterol can be increased. (21 listed in notes) Hypothyroidism, biliary obstruction, pregnancy, pancreatic disease, and stress
Name the 3 main ways bile can be obstructed. cancer of pancreas head, spasm of CBD, and gallstone in the CBD
Name the 6 main ways that total cholesterol can be decreased. (12 listed in notes) severe liver cell damage, hyperthyroidism, chronic anemia, malabsorption, malnutrition, and cancer
Is there a correlation between total cholesterol levels and what season it is currently? yes, can become about 8% higher in the winter
Is there a correlation between total cholesterol levels and the patient position when blood is drawn? yes, can be 10-15% lower when sitting or recumbent as opposed to standing
What are the 5 major categories for causes of high plasma cholesterol levels? inherited defect, disease of the endocrine system, liver disease, renal disease, and diet
At what age does the NCEP and AHA recommend cholesterol screening begin? at an interval of how many years if normal? if high? age 20 every 5 years every 2 years
Created by: okeywan