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Activity for the Topic: Lipid and Lipoproteins
1.1. Please answer the following questions COMPREHENSIVELY, and it should be in your OWN WORDS.
1.2. Answers should be in a paragraph form.
1.3. Cite your sources properly using the APA 6th referencing style.
1.4. Use short bond paper.
1.5. Font: Arial; Font size: 11 1.6. The Margin 1 inch by 1 inch.
1.7. Deadline: April 20, 2020
2. Activity Proper
2.1. Answer the following questions
2.1.1. What is cholesterols mechanism of absorption, synthesis, esterification, and metabolism?
2.1.2. Does the low-cholesterol diet translate to a lower risk of CHD?
2.1.3. Why is there a need to esterify cholesterols?
2.1.4. How does fatty acid contribute to the generation of energy via beta-oxidation process?
2.1.5. Why is there a presence of ketones in uncontrolled type 1 DM? Why is it absent in type 2 DM?
2.1.6. How does phospholipid differ with triglyceride?
2.1.7. How does LP(a) differ with LDL in terms of structure?
2.1.8. What are the roles of various lipoproteins
2.1.9. What are the functions of various apolipoproteins
2.1.10. How are chylomicrons formed? How do they reach the circulation starting from the intestines?
2.1.11. How does chylomicron transfer its lipid content to various tissues?
2.1.12. How does the intestinal pathway of lipoprotein metabolism work?
2.1.13. How does the hepatic pathway of lipoprotein metabolism work?
2.1.14. What happens to chylomicron remnants after the hydrolysis of its triglyceride content (at least two events)?
2.1.15. VLDL also contains cholesterol and has Apo B-100 that can interact with LDL receptors. Why is that it gives only its triglyceride contents to cells?
2.1.16. What are the two fates of VLDL remnants?
2.1.17. How does LDL deliver cholesterol to cells? Explain the mechanism
2.1.18. What are the two types of reverse cholesterol transfer pathways? Explain each.
2.1.19. What is the clinical significance of lipid and lipoprotein testing?
2.1.20. What lipids and lipoproteins are associated with a higher risk of developing
2.1.21. Aside from certain lipids and lipoproteins, what acute phase reactant is considered as a sensitive predictor of risk for CHD?
2.1.22. What are the various methods used in measuring lipids and lipoproteins? Explain each.
2.1.23. What are the reference methods for the following?
220.127.116.11. Total cholesterol
18.104.22.168. Lipoproteins (HDL, VLDL, Lp(a), LDL, Chylomicrons
2.1.24. What are the NCEP and ATP classifications of LDL, Total, and HDL Cholesterol?
2.1.25. What is the typical reference interval for triglycerides?
2.2. Case Analysis
Ana, a 40-year-old businesswoman, went to a clinic for a check-up. She complained of persistent abdominal pain, fever, and vomiting episodes. Upon physical examination, her temperature and pulse rate was 38.5C and 75 bpm, respectively. Further, the attending physician noticed the presence of raised, reddish-yellow bumps or nodules on her skin and the tenderness of her abdomen. Upon further interview, the patient admitted that the abdominal pains were recurrent, and she did not bother having herself checked until the pain became unbearable. Her clinical records showed that the has type 2 diabetes mellitus. Her sister suffered from the same complaint and died two years ago. The physician requested the performance of lab tests. The results are shown below:
Name of Test Result Reference Range
Triglyceride 45.2 mmol/L 0.11 – 2.15 mmol/L
Total Cholesterol 4.3 mmol/L 5.2 mmol/L
LDL-C 2.5 mmol/L 2.6 – 3.35 mmol/L
HDL-C 1.60 mmol/L 1.56 mmol/L
Serum amylase 556 U/L 30 – 220 U/L
LPL activity (pre heparin treatment) 0.25 umol/L/min 21.2 – 47.6 umol/L/min
LPL activity (post heparin treatment) 0.26 umil/L/min 21.2 – 47.6 umol/L/min
Glucose (Random) 13.9 mmol/L 4.4–7.8 mmol/L
Complete Blood Count
RBC count 4.6 x 1012/L 4.1–5.1 × 1012/L
Hematocrit 0.389 L/L 0.359–0.446 L/L
Hemoglobin 145 g/L 123–153 g/L
MCV 88 fL 80–96 fL
MCH 30 pg 27.5–33.2 pg
Name of Test Result Reference Range
MCHC 0.340 g/L 0.334–0.355 g/L
WBC Count 12.5 x 109/L 4.4–11.3 × 109/L
Neutrophil 80 50-70%
Bands 0 0-5%
Eosinophil 2 0-3%
Basophil 0 0-1%
Lymphocyte 25 20-30%
Monocyte 6 0-10%
Erythrocyte sedimentation rate 30 mm/hr 20 mm/hr
2.2.1. What is the most probable diagnosis of this patient? Why?
2.2.2. What other test/s is/are recommend to confirm diagnosis further?
2.2.3. This disease has almost a similar clinical picture with a specific disease.
What is that specific disease, and how will you differentiate the two?
2.2.4. What is the cause of this disease?