Fat, cholesterol and artherosclerosis

Question 1

What is a heart attack/myocardial infarction?

Answer 1

When blood supply is blocked to the heart and tissue dies

Question 2

What is a stroke?

Answer 2

When blood flow to the brain is blocked and tissue dies

Question 3

What is the Dotter procedure?

Answer 3

A percutaneous coronary intervention (gauze to open the blood vessel)

Question 4

How are proteins called that transport lipids through the blood?

Answer 4

Lipoproteins

Question 5

What do lipoproteins consist of?

Answer 5

• Proteins
• Phospholipids
• Neutral fat (triglycerides. cholesterol, cholesterolesters)

Question 6

Which lipoprotein has the most triglycerides and cholesterol ester?

Answer 6

Chylomicrons

Side 11

Question 7

Which lipoprotein has the most free cholesterol?

Answer 7

LDL (Low density lipoprotein)

Question 8

Atherosclerotic plaque is rich in?

Answer 8

cholesterol

Question 9

List the structures of an artery from outside to lumen

Answer 9

1. Adventitia
2. External elastic lamina
3. Tunica media
4. Internal elastic lamina
5. Subintimal extracellular space
6. Endothelial cell

Question 10

When macrophages take up oxidized LDL they form…?

Answer 10

Foam cells

Question 11

Which receptors on macrophages take up and mediate oxidized LDL?

Answer 11

LOX-1 and CD36

Question 12

When the fibrous cap of a vessel is destabalized by inflammatory cells what is the effect of that?

Answer 12

Formation of a Thrombus

Question 13

What is atherosclerosis?

Answer 13

Accumulation of fat/cholesterol in arterial intima causing inflammation or/and rupture

Question 14

What can an atherosclerotic plaque with thrombus develop into?

Answer 14

• Healed fissure with buried thrombus
• Mural intraluminar thrombus
• Occlusive thrombus

An occlusive thrombus can develop into a healed fissure but a healed fis

Question 15

What is reversed cholesterol transport?

Answer 15

Excess cholesterol is being removed from peripheral tissues and delivered to the liver by HDL

Question 16

Which effect does heterozygocity of ApoAI have on event-free survival?

Answer 16

Over the years, the people who havent had serious complications decline more than people with other alleles

Question 17

What is an effect of low HDL-c, independent of the fact that LDL-c may also be low?

Answer 17

Cardiovascular disease risk increasaes

Question 18

Which lifestyle factors decrease HDL-c levels?

Answer 18

• Testosterone
• Smoking
• Obesity
• Anabolic steroids (to increase muscle mass) and anti-epileptics

Question 19

Which factors increase HDL-c levels?

Answer 19

• Alcohol consumption
• Physical activity

Question 20

What is a better marker for CVD than cholesterol in women?

Answer 20

CRP (produced as acute phase response)

Question 21

Why is CRP a better marker for CVD in women?

Answer 21

Because half of CV events occur withour hyperlipidemia

Question 22

What is metabolic syndrome?

Answer 22

Combination of obesity, cholesterol levels, hypertension and high BMI

Question 23

What does adipose tissue release that are key factors in metabolic syndrom signalling?

Answer 23

Interleukins and TNF-alpha

Question 24

What does interleukin 6 and TNF-alpha cause?

Answer 24

• Hypertension
• More glucose production
• More VLDL production
• Less HDL cholesterol
• More adipose tissue

Question 25

When does oxidative stress increase in the mitochondria?

Answer 25

When fatty acids increase

Question 26

Is high or low CRP in women bad?

Answer 26

High

Question 27

Steps of the forward cholesterol transport:

Answer 27

1. VLDL 2. IDL 3. LDL 4. Peripheral tissues

Question 28

Cholesterol is a precursor for?

Answer 28

* Bile acids * Steroid hormones

Question 29

Which enzyme extract cholesterol from food?

Answer 29

Cholesterol esterase

Question 30

Which lipoproteins are released after a meal produced by epithelial cells?

Answer 30

Chylomicrons

Question 31

How much % of plasma cholesterol is made by the liver

Answer 31

80%

Question 32

Which metabolites lead to acetyl CoA?

Answer 32

* Pyruvate * Ethanol * Acetoacetate * Fatty acids

Question 33

What is the precursor metabolite of cholesterol?

Answer 33

Acetyl CoA

Question 34

From which metabolite to which substance is cholesterol synthesis fully comitted?

Answer 34

From Acetyl CoA to mevalonate

Question 35

Cholesterol synthesis uses how many ATP?

Answer 35

3 ATP

Question 36

Which compound that is produced in PPP stimulates cholesterol production?

Answer 36

NADPH

Question 37

Via which lipoprotein are carbohysrates and proteins transported from the liver to produce cholesterol and fatty acids?

Answer 37

VLDL

Question 38

What does LDL receptor deficiency lead to?

Answer 38

Very high plasma cholesterol levels and accumulation of cholesterol in tissues

Question 39

How are LDL particles normally taken up?

Answer 39

Via clathrin coated pit endocytosed when binding to LDL receptor

Question 40

Which hormone regulates cholesterol synthesis?

Answer 40

Insulin

Question 41

What are statins?

Answer 41

Cholesterol lowering drugs

Question 42

To what extent does simvastatin reduce risk for myocardial infarct?

Answer 42

30%

Question 43

How can cholesterol synthesis be inhibited in order for HMG-coa not to bind to HMG CoA reductase?

Answer 43

Competitive inhibitor

Question 44

What is HMG CoA reductase regarding cholesterol?

Answer 44

Rate limiting step to cholesterol

Question 45

What happens to cholesterol levels when HMG CoA is inhibited competitively?

Answer 45

Km increases, lower affinity, less cholesterol produced

Question 46

Does simvastatin have a high or low affinity to HMG CoA reductase?

Answer 46

High

Question 47

Why do statins work?

Answer 47

They have higher affinity for enzymes than natural substrates

Question 48

What are omega 3 and 6 the precursors of?

Answer 48

arachidonic acid

Question 49

What derive from arachidonic acid and are short lived local signalling molecules?

Answer 49

Eicosanoids (C20)

Question 50

What are examples of eicosanoids?

Answer 50

* Prostaglandins * leukotrienes * Thromboxanes * Lipoxins

Question 51

What do eicosanoids mostly cause?

Answer 51

Constriction, contraction, aggregation of plasma factors (immune cells and platelets)

Question 52

What substances decrease prostaglandins?

Answer 52

* Glucocorticoids * Aspirin

Question 53

which enzyme converts arachidonic acid to prostaglandins?

Answer 53

Cyclooxygenase

Question 54

Which enzyme does aspirin inhibit?

Answer 54

Cyclooxygenase | decreases production of prostaglandins

Question 55

What do pain killers cause physiologically?

Answer 55

Stomach ulcers and intestinal bleedings

Question 56

What does COX 1 do?

Answer 56

* Protects stomach/intestine * Mucus

Question 57

What does COX 2 do?

Answer 57

Inflammation

Question 58

To reduce information, which COX enzyme needs to be inhibited?

Answer 58

COX 2

Question 59

What is important when inhibiting COX 2?

Answer 59

Choosing the right dose so the drug does not have a high affinity to COX 1 too

Question 60

What is the function of leukotrienes?

Answer 60

Inflammation and pain

Question 61

Function of thromboxanes?

Answer 61

Thrombosis and platelets

Question 62

Function prostacyclin? | Produced by COX 1

Answer 62

Vascular dilation

Question 63

Which cyclooxygenase causes most problems when there is alot of omega 3 and 6?

Answer 63

COX 2