M.I. 01.15

Question 1

Conversion of arachadonic acid in cell membranes to prostaglandin h2 (prostoglandin precursor) is by which enzyme?

Answer 1

COX - cyclo oxygenase

Question 2

This enzyme converts prostaglandin H2 into Prostacyclin, PGE2 and PGD/PGF

Answer 2

Cox 1

Question 3

This enzyme in platelets converts prostaglandin H2 into Thromboxane A2

Answer 3

Cox 2

Question 4

Thromboxane A2 is bad for the CVS in 2 ways

Answer 4

1. Platelet agonist - promotes clots

2. Vasoconstrictor

Question 5

Arachidonic acid is converted to Leukotrienes (causing broncho constriction) by which enzyme

Answer 5

Lipo oxygenase

Question 6

Which prostaglandin is protective for the stomach

Answer 6

PGE2

Question 7

What 3 groups of prostaglandins

are converted from prostaglandin H2 (PGH2) by COX1, & have what 3 main effects?

Answer 7

1. PDG / PGF - pro inflammatory, pain fever
2. PGE2 - protective for stomach
3. PGI2/ Prostacyclin - protective for vasculature -platelet inhibition & vasodilation

Question 8

What 3 main effects do non-selective NSAIDs have on body e.g. Aspirin, Ibuprofen

Answer 8

1. Reduce inflammation
2. Reduce stomach protection - GI irrit.
3. Reduce thromboxane prod - prevent platelet function

Question 9

Celecoxib, Meloxicam, Etodolal are all examples of what type of NSAID

Answer 9

Cox 2 selective

Question 10

This is a pro-drug, activated by CYP450, which blocks ADP receptor on platelets, thus preventing platelet activation

Answer 10

Clopidogrel

Question 11

How do ACE inibitors control BP

Answer 11

Prevent conversion of angiotensin I to angiotensin II

Question 12

Digoxin is an example of what type of inotrope

Answer 12

Positive - increases contractility of heart

Question 13

Bisoprolol is an example of what type of inotrope

Answer 13

Negative - decreases contractility of heart

Question 14

Familial hypercholesterolaemia (IIa) is associated with disorder of which chromasome?

Answer 14

19

Question 15

These lipoproteins carry fat from the intestine - they release triglycerides & some cholesterol in the liver.

Answer 15

Chylomicrons

Question 16

These lipoproteins transport cholesterol back to the liver for excretion and are associated with better health outcomes.

Answer 16

HDL

Question 17

Unburned food metabolites are converted into this and secreted into the plasma by the liver

Answer 17

VLDL

Question 18

3 main ingredients of chylomicrons?

Answer 18

Long chain f.a.s
Cholesterol
Protein

Question 19

Frederickson type II lipid disorder assoc with what condition

Answer 19

Lipoprotein lipase deficiency

Question 20

Frederickson type IIa lipid disorder assoc with what condition? (among others)

Answer 20

Familial hypercholesterolaemia

Question 21

Frederickson type IIb lipid disorder assoc with what condition

Answer 21

Familial combined

hyperlipidemia

Question 22

Frederickson type III lipid disorder assoc with what condition

Answer 22

Dysbetalipoproteine

mia

Question 23

Frederickson type IV lipid disorder assoc with what condition (among others)

Answer 23

Familial

hypertriglyceridemia

Question 24

Frederickson type V lipid disorder assoc with what condition

Answer 24

Diabetes

Question 25

Diff between primary and secondary hyperlipidaemia?

Answer 25

1ary - inherited / genetic | 2ary - assoc with other conditions e.g diabetes

Question 26

These 3 conditions (and many more) are assoc with 2ary hyperlipidaemia

Answer 26

DM Hypothyroidism Nephrotic syndrome

Question 27

Why should pregnant women be aware of their cholesterol

Answer 27

Risk of hyperlipidaemia

Question 28

``` What 2 conditions may be assoc with these signs: •tendinous xanthomas •corneal arcus •premature CAD •family history of hypercholesterolemia ```

Answer 28

1. Heterozygous familial hypercholesterolaemia | 2. Familial defective apolipoprotein B

Question 29

``` What condition is assoc with: •usually >30 yr old •often overweight •usually no xanthomas •premature CAD •different generations have different lipoprotein abnormalities ```

Answer 29

Familial combined hyperlipidemia

Question 30

What condition is assoc with: •premature CAD •no xanthomas •no family history of hypercholesterolemia

Answer 30

Polygenic hypercholesterolemia

Question 31

yellow palmar creases assoc with what condition?

Answer 31

Dysbetalipoproteinemia

Question 32

``` •often overweight •>30 yr old •often diabetic •hyperuriaemic •may or may not have premature CAD •determined by family history and HDL-C Assoc with what condit? ```

Answer 32

Familial hypertriglyceridemia

Question 33

``` usually middle-aged •often obese •often hyperuricaemic •usually diabetic •risk for recurrent pancreatitis assoc with ? ```

Answer 33

Severe hypertriglyceridemia

Question 34

What 3 criteria are definitive for familial hypercholesteraemia diagnosis?

Answer 34

1. Total cholesterol above 7.5 mmol/l (in adults) 2. or LDL cholesterol above 4.9 mmol/l (in adults) 3. PLUS tendon xanthomata in the patient or in a first- or second degr relative

Question 35

Receptor for what substance is coded for on chromos. 19

Answer 35

LDL

Question 36

Mutations in what receptor cause problems in FamHyperchol

Answer 36

LDL receptor

Question 37

What drugs are HMG CoA reductase inhibitors - used for lowering cholesterol

Answer 37

Statins

Question 38

ciprofibrate, gemfibrizil, bezafibrate, fenofibrate are examples of what triglyceride-lowering drugs

Answer 38

Fibrates

Question 39

What are 2 types of atheromatous plaque

Answer 39

Concentric - fills whole lumen | Eccentric - sticks out into lumen

Question 40

What initiates plaque formation in arteries (3 egs of causes)

Answer 40

Endothelial damage (smoking, hypertension, DM)

Question 41

Once arterial damage occurs what is the next stage in atherosclerosis

Answer 41

Activation of platelets and monocytes - migrate to endothelial space. Smooth muscle cells proliferate here "remodelling", cholesterol accumulates, WBCs absorb lipid & convert to fatty "foam cells".

Question 42

What forms the "fibrous cap" of a plaque

Answer 42

Collagen and smooth muscle cells

Question 43

What would you see on ECG in a complete occlusion of coronary artery MI?

Answer 43

STEMI - st elevation

Question 44

What would you see on ECG in a partial occlusion of coronary artery MI?

Answer 44

NSTEMI - st depression