Metabolic

Question 1

What are the 3 sources of blood cholesterol

Answer 1

• dietary sources of free cholesterol
• synthesis in the liver
• bile acid reabsorption

Question 2

What is cholesterol used for in the body

Answer 2

• cell membranes
• bile acids
• steroid hormones

(not an energy source, just a building block)

Question 3

What are the two sources of blood triglycerides

Answer 3

• directly assembled in GI tract after intestinal absorption for quick energy delivery
• synthesized in the liver for sustained energy delivery

Question 4

What are triglycerides used for

Answer 4

• formation of cell membranes
• formation of hormones
• ENERGY!

Question 5

Describe the 2 types of fatty acids

Answer 5

• unsaturated: can be used for energy and ARE important building blocks for cell membrane/steroids
• saturated: can be used for energy and aren’t as important as building blocks

Question 6

What are cholesterol and triglycerides transported by? (4 main ones)

Answer 6

Lipoproteins
- chylomicrons
- VLDL (very low density lipo)
- LDL (low density lipo)
- HDL (high density lipo)

Question 7

Describe how LDL is calculated

Answer 7

LDL = total cholesterol - (VLDL + HDL)

calculation not valid for triglyceride >400 mg/dL

Question 8

What are some etiologies for lipid abnormalities

Answer 8

• mostly dietary or genetic

Question 9

What is one of the most commonly prescribed drugs in the world

Answer 9

statins

Question 10

Describe the MOA of a statin

Answer 10

reduces cholesterol synthesis in the liver which decreases LDL, VLDL, triglyceride production

Question 11

Describe some known side effects of statins

Answer 11

• elevated transaminases (AST, ALT)
• diabetes
• muscle pain/injury (benign myalgias, myopathy, serious rhabdomyolysis)

Question 12

What are some contraindications to statins

Answer 12

Question 13

List the high/moderate intensity statins

Answer 13

Rosuvastatin & atorvastatin

Question 14

List the low/moderate intensity statins

Answer 14

Simvastatin, pravastatin, lovastatin, fluvastatin

Question 15

What is the MOA of cholesterol absorption inhibitors

Answer 15

blocks the absorption of dietary/biliary cholesterol at the brush border of the intestine

Question 16

What is the MOA of omega-3 fatty acids & fibrates

Answer 16

decreases VLDL production & increases lipoprotein lipase activity

Question 17

Describe the clinical criteria for metabolic syndrome

Answer 17

3+ meets criteria: obesity, impaired fasting glucose/DM, HTN, low HDL, elevated triglycerides