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Clinical Chemistry > Lipids Exam 3 > Flashcards

Lipids Exam 3 Flashcards

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1
Q

Lipids are ____ in water but ____ in organic solvents

A

insoluble ; soluble

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2
Q

Triglycerides consist of

A

fatty acids + glycerol
major storage form

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3
Q

Phospholipids consist of

A

glycerol backbone
2 fatty acids + phosphoric acid group

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4
Q

Sterol characteristics

A

Cholesterol most important
serves as backbone for steroids
vitamin d - 2/3 esterified form

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5
Q

What is a lipoprotein made up of?

A

Triglycerides and cholesterol (mix of apoliproteins)

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6
Q

What is the main role of lipoproteins?

A

Delivery of fuel to peripheral cells; “core” being the cargo

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7
Q

What is the largest and least dense of all lipoprotein particles?

A

Chylomicrons

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8
Q

Chylomicrons are produced by

A

Intestine and packaged with absorbed dietary lipids.

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9
Q

The principle role of chylomicrons is

A

the delivery of dietary lipids into hepatic and peripheral cells

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10
Q

Chylomicrons transport _____ from the _____ to the _____

A

Triglycerides ; intestine ; adipose cells

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11
Q

Apoliprotein B-48 is associated with

A

Chylomicrons

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12
Q

Very low density lipoproteins (pre beta) are made up of

A

mostly triglycerides

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13
Q

Which lipoprotein is a major carrier of endogenous triglycerides into peripheral tissue during fasting for energy and storage?

A

Very low density lipoproteins

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14
Q

APO protein B-100 associated with

A

Very low density lipoproteins
Low density lipoproteins
Lipoprotein A

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15
Q

Which lipoprotein is found in patients with type 3 hyperlipoproteinemia?

A

Intermediate Density Lipoproteins

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16
Q

Hyperlipoproteinemia puts patients at risk for

A

peripheral vascular disease (PVD) and Coronary Artery disease (CAD), and damages vessel wall like LDL

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17
Q

LDL or Beta is made up of

A

Cholesterol, and principally carries it.

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18
Q

What lipoprotein was formed as a consequence of lipolysis of VLDL?

A

LDL

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19
Q

Where is LDL readily taken up?

A

via LDL receptor in liver and peripheral cells

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20
Q

What lipoproteins are better markers for CHD risk?

A

the 8 LDL subclasses that are separated by ultracentrifugation or electrophoresis

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21
Q

Elevated levels of this lipoprotein increase risk of premature CHD and Stroke

A

Lipoprotein A (>30 mg/dl)

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22
Q

Lipoprotein A competes with _____ for binding sites on endothelium and on fibrin, which promotes clotting (stroke)

A

Plasminogen

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23
Q

Who should get their Lipoprotein A measured?

A

Strong family history of CHD
Developed CHD on statin therapy
Premature Aortic stenosis (high lp(a) levels)

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24
Q

What lipoprotein is the smallest and most dense and removes cholesterol from cells and takes it to the liver for removal?

A

High density Lipoproteins (reverse cholesterol transport)

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25
High density lipoproteins are synthesized by
Liver and intestine
26
Which lipoprotein can exist as disk-shaped or spherical particles?
High density lipoproteins
27
This lipoprotein is abnormal and present in biliary cirrhosis or choleostasis
Lipoprotein X
28
Lipoprotein X consists of
Phospholipids and nonesterfied cholesterol
29
In the exogenous pathway, what enzyme converts dietary lipids into polar compounds making them amphipathic?
Lipase
30
Which Hydrolytic enzymes from the pancreas process lipids?
Lipase (breaks down triglycerides) Cholesterol esterase (releases free cholesterol) Phospholipase A (hydrolyzes phospholipids)
31
What is lipoprotein Lipase's role in the exogenous pathway?
clears chylomicrons and breaks down triglycerides
32
Triglycerides are converted to
fatty acids by cells and ready to be used for energy
33
Excreted biliary cholesterol appears in
stool (fecal neutral steroids)
34
Triglycerides that are packaged into VLDL in the endogenous pathway are split into? by which enzyme?
They are split in IDL's and VLDL remnants ; lipoprotein lipase
35
Cleaved IDL's have two fates in the endogenous pathway:
They could either receive cholesterol esters from HDL in exchange for triglycerides, or be made into LDL in the liver by removing triglycerides
36
VLDL remnants have two fates in the endogenous pathway:
They could either be taken up in the liver, or be made in to LDL which delivers cholesterol to peripheral cells because of the LDL receptors.
37
Triglycerides inside the cell in the endogenous pathway are converted to
Free fatty acids and glycerol by the cell for energy
38
What enzyme transports excess cholesterol from the cell?
Lecithin cholesterol acyltransferase
39
What is HDL's role in the endogenous pathway?
takes cholesterol back to the liver for disposal in bile salts
40
What happens if cells are full in the endogenous pathway?
LDL forms plaques
41
LDL receptors regulate
Cellular cholesterol biosynthesis and degradation
42
Hypercholesterolemia and premature atherosclerosis are abnormalities in
LDL receptor regulation
43
What enzyme converts cholesterol into Cholestryl ester (HDL3) in the aqueous diffusion pathway?
LCAT enzyme
44
HDL2 delivers cholesterol to
Liver
45
What is the end product of the aqueous diffusion pathway?
Cholesterol in liver directly excreted into bile or converted to bile acid.
46
The ABCA1 transporter is
A member or ATP binding cassette transporter family
47
The principle function of the ABCA1 transporter is to
enable APO A-1 from HDL to bind to cell membrane and in a detergent like mechanism, remove excess cholesterol and phospholipid from cells
48
HDL forms what shape to accept additional cholesterol?
discoid shape
49
What enzyme converts discoid shape HDL to spherical HDL?
LCAT
50
Cell based assay tests the
capacity of cholesterol loaded macrophages to efflux cholesterol through ABCA1 transporter
51
What assay provides additional knowledge of HDL function?
Cell-based assay
52
The cell based assay is found to be inversely corelated with
intima media thickness and with presence of CHD (disease status)
53
Low levels of cell based assay can be associated with
atherosclerotic cardiovascular disease
54
The analysis of lipids includes
total amount of all lipoproteins
55
What reagent is used for the colorimetric method of cholesterol and what is the name of the method?
Abell Kendall method Liebermann buchard color reagent Acetic acid, acetic anhydride and sulfuric acid produce green color
56
What is the reference method for cholesterol?
Gas chromatography mass spectrophotometry, not related sterols, cholesterol only.
57
What interferes with the Colorimetric- Abell Kendal method?
Hemoglobin, bilirubin, water (causes cloudiness)
58
What can cause increase in cholesterol values?
An increased cholesterol level can indicate an increased risk of CHD may be caused by diabetes, estrogen, hypothyroidism
59
What are the pre analytical factors that influence values of cholesterol?
Stress, diurnal variation, higher in the winter
60
in post mortem specimens, why is blanking necessary for triglycerides?
triglycerides rapidly convert to glycerol after death
61
Within triglyceride methods, what is measured?
Include the hydrolysis of triglyceride to form glycerol and fatty acids; measures glycerol
62
In the enzymatic method for triglycerides, what two enzymes are coupled together and what do they produce?
Glycerol kinase and Glycerophosphate oxidase coupled to same peroxidase color reaction used in cholesterol
63
What does alkaline hydrolysis form in the colorimetric method in triglycerides?
Glycerol
64
What does glycerol oxidize to in the colorimetric method in triglycerides?
Formaldehyde and formic acid
65
What is the color development in the van handel and zilversmith reaction in triglyceride colorimetric method?
Formaldehyde and chromotropic acid will form pink color
66
What is the reaction in Hantzch condensation in triglyceride colorimetric method?
Formaldehyde, ammonium ion, and acetyl acetone will form diacetyl lutidine
67
What condition increases as HDLc decreases?
Coronary heart disease
68
How is HDL analyzed?
selective precipitation, divalent cations in solution of buffer, heparin, or dextran sulfate. Will precipitate VLDL and LDL leaving HDL.
69
What increases HDL Levels?
Weight reduction Jogging Estrogen Alcohol
70
What could interfere with calculating LDL
presence of chylomicrons
71
What LDL sub particle is smaller and denser, more responsive to statin drugs and niacin, and imposes a risk of CHD?
Pattern B
72
What LDL sub particle is larger and less dense, and is more responsive to fibrates or niacin. And lowers triglyceride, but has side effects of flushing?
Pattern A
73
What drugs can be used to manage lipid levels?
Statins and Repatha
74
What is the primary prevention for those at risk of CVD?
Statins, Atorvastin, Fluvrastatin.
75
Statins are
HMG- COA reductase inhibitors, they are lipid lowering medication by decreasing LDLc.
76
What are the side effects of statins?
Myalgia, rhabdomyolysis, liver damage
77
Repatha can be defined as
monthly injections to decrease LDLc, it is beneficial for those with myalgia from statins.

Clinical Chemistry (10 decks)

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