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CP2 Lipids pt 1
Basic Lipid Questions
| Question | Answer |
|---|---|
| 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
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