Health Questions and Answers

Archive for the 'Lipid Disorder' Category

Question: What are the important risk factors for cardiovascular disease?

Sunday, May 25th, 2008

Answer:

 

Age: male ≥ 45 years, female ≥ 55 years
Family history: coronary heart disease (CHD) in a male first-degree relative < 55 years or female first-degree relative < 65 years
Current cigarette smoking
Hypertension (≥ 140/90 mmHg or on antihypertensive medications)
Low HDL cholesterol: < 40 mg/dL (Note: High HDL-c is a negative risk factor; if the patient has [...]

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Question: How should you screen for lipid disorders?

Saturday, May 24th, 2008

Answer:
Current recommendations for screening and treatment are based on the National Cholesterol Education Program guidelines that were last revised in 2001. It is recommended that adults 20 years or older have a screening fasting lipid profile obtained every 5 years (more often if they are at high risk). Treatment is based on determining the patient’s [...]

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Question: How is chylomicronemia syndrome treated?

Friday, May 23rd, 2008

Answer:
Treatment is aimed at reducing triglyceride levels and may require fasting to lower the triglyceride levels into a safer range. 
Reference: Basa ALP, Afsharkharaghan H (Zollo A, ed): Endocrinology in Medical Secrets, 3rd ed. 2001.

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Question: What are the physical manifestations of chylomicronemia syndrome?

Thursday, May 22nd, 2008

Answer:
Physical manifestations of this syndrome include lipemia retinalis, eruptive xanthomas, and hepatomegaly. Patients are at increased risk of developing pancreatitis. 
Reference: Basa ALP, Afsharkharaghan H (Zollo A, ed): Endocrinology in Medical Secrets, 3rd ed. 2001.

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Question: What is the chylomicronemia syndrome?

Wednesday, May 21st, 2008

Answer:
The chylomicronemia syndrome typically occurs when triglyceride levels are > 1000 mg/dl. Patients develop severe triglyceride elevations when the enzyme lipoprotein lipase (LPL), which is responsible for triglyceride hydrolysis of chylomicrons and very low density lipoprotein (VLDL), becomes saturated and is no longer able to clear chylomicrons from the circulation. When the LPL enzyme becomes [...]

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Question: What is familial hypercholesterolemia (FH)?

Tuesday, May 20th, 2008

Answer:
FH is an autosomal dominant disorder due to a mutation in the LDL receptor (causing a deficient or defective receptor) that leads to altered LDL catabolism and increased cholesterol synthesis. Approximately 1/500 people are heterozygous carriers of a mutation and 1/1,000,000 are homozygous for the disorder. Such people have much higher rates of premature atherosclerosis [...]

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Question: What are the major classes of lipoprotein particles?

Monday, May 19th, 2008

Answer:
Lipoproteins are named based on their density and are composed of nonpolar (and therefore water-insoluble) cholesterol esters and triglycerides surrounded by a layer of polar (and therefore water-soluble) proteins and lipids (unesterified cholesterol and phospholipids). This structure allows the entire particle to remain miscible in serum.
LIPOPROTEIN PARTICLES

Lipoprotein Particle
Location of Origin
Composition
Apoproteins
Associated Disorders

Chylomicron
Intestine
80-95% TG
Apo B48
Chylomicronemia

 
 
3-7% chol
 
 

VLDL
Liver
50-65% TG
Apo [...]

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