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Flashcards in Lipids in heart disease Deck (53)
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1

Why are lipids needed in the body

- Importatn in constituent of the cell membranes
- helps in the absorption of fat soluble vitamins
- maintains membrane fluidity
- acts as a thermal insulator adn cellular metabolic regulator
- hormone synthesis - steroid synthesis
- organ padding

2

What are the fat soluble vitamins

A
B
E
K

3

What enzyme do statins inhibit

- HMG CoA reductase

4

What do statins lower

- Cholestrol level

5

What is cholestrol important for

- Vitamin D syntehsis
- steroids
-bile salts

6

What are modifiable cardiovascualr risk factors

- smoking
- high cholestrol
- hypertension
- high blood glucose
- obesity

7

What are the unmodifiable risk factros for cardiovascular disease

- Age
- gender
- family history
- ethinicty

8

The smaller the molecule

the smaller the moelcule the easier it is to penetrate between the endoithelial cells and go into the endothelium
- therefore easy for LDl molecules to get in adn less easy for VLDL adn IDL

9

Describe how LDLs, HDLs and chylomicrons work together

- Chylomicrons transport fat from the itnestinal mucsoa to the liver
- in the liver some of the chylomicrons release triglycerides and some cholestrol and become low density lipoproteins (LDL)
- LDL then carries fat and cholestrol to the bodys cells
- High density lipoproteins (HDL) Ccarr fat and cholestrol back to the liver for excretion

10

What is the difference between HDL and LDL

- LDL then carries fat and cholestrol to the bodys cells
- High density lipoproteins (HDL) Ccarr fat and cholestrol back to the liver for excretion

11

What are the two types of hyperlipidaemias

Primary
Secondary (more common)

12

What are causes of secondary hyperlipidaemia

∗ Diet
∗ Alcohol
∗ Hypothyroidism
∗ Nephrotic syndrome
∗ Anorexia nervosa
∗ Obstructive liver disease
∗ Obesity
∗ Diabetes mellitus
∗ Pregnancy
∗ Acute hepatitis
∗ Systemic lupus erythematousus
∗ Drugi nduced-Thiazides, B-blockers, anti retroviral drugs, anti-depressants

13

What do you look for in a fasting lipid profile

∗ Serum total cholesterol
∗ Serum LDL-cholesterol
∗ Serum (fasting) triglyceride
∗ Serum HDL cholesterol
∗ Cholesterol-HDL ratio

14

What is the friedewald formula

The Friedewald formula (FF) is an estimation of LDL-c level that uses the following levels of
- total cholesterol (TC),
- triglycerides (TG)
- high-density lipoprotein cholesterol (HDL-c):

LDL-c (mg/dL) = TC (mg/dL) − HDL-c (mg/dL) − TG (mg/dL)/5 [6, 11–13].

15

What levels do you use in the Friedewald formula (FF)

- total cholesterol (TC),
- triglycerides (TG)
- high-density lipoprotein cholesterol (HDL-c):

LDL-c (mg/dL) = TC (mg/dL) − HDL-c (mg/dL) − TG (mg/dL)/5 [6, 11–13].

16

What does the serum look like if you have high triglyceride

serum looks white

17

What can happen with high triglyercide

acute pancretitis

18

What causes primary hyperlipidaemia

genetic

19

Name a type of primary hyperlipidaemia

- Familial Hypercholesterolemia (FH)
- familial combined hyperlipideaemia
- dysbetalipoproteinemia

20

What happens in Familial Hypercholesterolemia (FH)

- Codominant genetic disorder, occurs in
heterozygous form

- Mutation in LDL receptor, resulting in elevated levels of LDL at birth and throughout life

21

What are pateints with Familial Hypercholesterolemia (FH) at risk of

- Atheroscloeris
- tendon xanthomas (75% of patients)
- tuberous xanthomas
- xathelasmas of eyes

22

what is the genetics of familial combined hyperlipidaemia

- Autosomal dominant

23

What is there increased secretion of in familial combined hyperlipidaemia

- Increased secretions of VLDLs

24

What happens in dysbetalipoproteinemia

Results in apo E2, a binding-defective form of apoE (which usually plays important role in catabolism of chylomicron and VLDL)

25

What can dysbetalipoproteinemia cause an increase risk of

- atherosclerosis
- peripheral vascualr disease
- tuberous xanthomas
- striae palmaris

26

What are the two sources of cholestrol

- diet
- liver synthesises cholestrol

27

What happens if the body is deficient or resistant in lipoprotein lipase

increases amount of chylomicron leading to increased cholestrol in ciruclation

28

What is the genetics of Familial Hypercholesterolemia (FH)

- Autosomal dominant

29

What is a high risk of Familial Hypercholesterolemia (FH)

- high risk of premature CHD - have to identify those with FH
- early treatment leads to a near normal life expectancy
- over 50% risk of CHD in men by age 50 and at least 30 % risk in women by age 60

30

What criteria can you use to diagnose FH

- Simon Broome criterai