A particle with a shell of protein and phospholipid that carries cholesterol and other lipids through the watery blood is a lipoprotein.
Missing Word
lipoprotein
Lipids do not dissolve in blood, so they travel inside lipoproteins such as chylomicrons, VLDL, LDL and HDL. The proteins on the surface direct each particle to its receptors and enzymes.
Category: Lipoproteins and Lipids
Question 2
An abnormal amount or imbalance of blood lipids, including a low HDL level with otherwise normal values, is called dyslipidemia.
Missing Word
dyslipidemia
Dyslipidemia is the broad term for any abnormal lipid pattern. Hyperlipidemia refers only to excess lipids, so a low HDL level fits dyslipidemia but not hyperlipidemia.
Category: Lipoproteins and Lipids
Question 3
The particle that the liver packages and releases to deliver newly made fat to muscle and adipose tissue is VLDL.
Missing Word
VLDL
Very low-density lipoprotein is made by the liver and is rich in triglycerides. As lipoprotein lipase strips its triglycerides, it becomes IDL and then LDL.
Category: Lipoproteins and Lipids
Question 4
The more severe form of familial hypercholesterolemia, which causes very high cholesterol and cardiovascular disease starting in childhood, is the homozygous form.
Missing Word
homozygous
A person with homozygous familial hypercholesterolemia inherits an abnormal gene from both parents and has far fewer working LDL receptors than a person with the heterozygous form, so LDL is extremely high from early life.
Category: Lipoproteins and Lipids
Question 5
A yellowish fatty deposit in a tendon or in the skin over the knuckles, knees or elbows, a sign of familial hypercholesterolemia, is called a xanthoma.
Missing Word
xanthoma
Xanthomas form when cholesterol-laden cells collect in tendons or skin. A swollen, painful Achilles tendon from a xanthoma is one physical clue to familial hypercholesterolemia.
Category: Lipoproteins and Lipids
Question 6
Effects of statins that go beyond lowering cholesterol, such as reducing vascular inflammation and stabilizing atherosclerotic plaque, are described as pleiotropic.
Missing Word
pleiotropic
Pleiotropic means producing several different effects. The anti-inflammatory, antioxidant and plaque-stabilizing actions of statins help explain their benefit in preventing coronary events.
Category: Statins
Question 7
The high-intensity statin that is metabolized mainly by CYP3A4 is atorvastatin.
Missing Word
atorvastatin
Atorvastatin and rosuvastatin are the two statins that reach high intensity. Rosuvastatin undergoes little CYP metabolism, while atorvastatin depends on CYP3A4, so CYP3A4 inhibitors raise atorvastatin levels and the risk of muscle injury.
Category: Statins
Question 8
Besides evolocumab, the other PCSK9 monoclonal antibody that patients self-inject to lower LDL is alirocumab.
Missing Word
alirocumab
Alirocumab and evolocumab both bind PCSK9 and are self-injected subcutaneously. The suffix mab marks them as monoclonal antibodies.
Category: PCSK9-Targeting Drugs
Question 9
The bile acid sequestrant that is also approved to improve blood glucose control in adults with type 2 diabetes is colesevelam.
Missing Word
colesevelam
Colesevelam lowers LDL and also modestly lowers glucose in type 2 diabetes. Like other sequestrants, it can raise triglycerides and cause constipation.
Category: Bile Acid Sequestrants
Question 10
Severe constipation from bile acid sequestrants can worsen hemorrhoids, swollen veins in the anal canal.
Missing Word
hemorrhoids
Hemorrhoids are dilated veins in the anal canal that become more painful and may bleed with straining. Fluids, fiber and a stool softener help prevent this complication of sequestrant therapy.
Category: Bile Acid Sequestrants
Question 11
The main storage form of fat in adipose tissue, made of glycerol joined to fatty acid chains, is the triglyceride.
Missing Word
triglyceride
Triglycerides are the main fat in the diet and in fat tissue. Lipoprotein lipase splits them so the fatty acids can be used for energy, and very high blood levels raise the risk of acute pancreatitis.
Category: Lipoproteins and Lipids
Question 12
Fibrates increase the amount of cholesterol secreted into bile, so a patient taking one is taught to report pain in the right upper abdomen, which can signal stones in the gallbladder.
Missing Word
gallbladder
Fibrates raise the cholesterol content of bile, which can form gallstones, so preexisting gallbladder disease is a contraindication and right upper abdominal pain, especially after fatty meals, is reported to the provider. The nurse also asks about a history of gallbladder problems before therapy starts.
Category: Fibrates
Question 13
Statins reduce heart attacks and strokes mainly by slowing atherosclerosis, the buildup of cholesterol-rich plaque inside the walls of arteries.
Missing Word
atherosclerosis
In atherosclerosis, LDL cholesterol enters the artery wall and builds plaque that narrows the vessel and can rupture and trigger a clot. Lowering LDL with a statin slows plaque growth and helps stabilize existing plaque, which lowers the risk of myocardial infarction and stroke.
Category: Lipoproteins and Lipids
Question 14
Prescription vitamin B3 therapy can cause hyperuricemia, a raised blood level of uric acid that can trigger gout.
Missing Word
hyperuricemia
Hyperuricemia means excess uric acid in the blood. Because niacin can raise uric acid, it is used with caution in patients with gout.
Category: Niacin
Question 15
The cholesterol absorption inhibitor that blocks the NPC1L1 transporter in the small intestine is ezetimibe.
Missing Word
ezetimibe
Ezetimibe blocks the Niemann-Pick C1-Like 1 transporter, so less dietary and biliary cholesterol is absorbed. It is often added to a statin when LDL remains above goal.
Category: Ezetimibe