High-Density Lipoproteins (HDLs) Overview
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Questions and Answers

What physiological change during pregnancy is primarily associated with the risk of cholesterol gallstones?

  • Enhanced lipid absorption
  • Increased blood viscosity
  • Reduced bile salt production
  • Slowed gallbladder function (correct)
  • Which hormones are speculated to contribute to slowed gallbladder function during pregnancy?

  • Cortisol and adrenaline
  • Estrogen and progesterone (correct)
  • Insulin and glucagon
  • Thyroxine and calcitonin
  • What is a symptom associated with the accumulation of bile salts due to slowed gallbladder function?

  • Pruritus (correct)
  • Fatigue
  • Muscle cramps
  • Nausea and vomiting
  • What is the primary process by which bile salts are formed in the liver from cholesterol?

    <p>Hydroxylation and oxidation</p> Signup and view all the answers

    Which two primary bile acids are formed from cholesterol in the liver?

    <p>Cholic acid and chenodeoxycholic acid</p> Signup and view all the answers

    What role do bile salts play in the digestive process?

    <p>They aid in lipid digestion</p> Signup and view all the answers

    What can be a consequence of prolonged accumulation of bile salts in the body?

    <p>Jaundice</p> Signup and view all the answers

    How are bile salts transported in the body after being formed in the liver?

    <p>In the portal circulation</p> Signup and view all the answers

    What can cholestyramine interfere with in relation to fat soluble vitamins?

    <p>Absorption of fat soluble vitamins</p> Signup and view all the answers

    What size of cholesterol gallstones can still be dissolved by Ursodeoxycholic acid?

    <p>6mm or less</p> Signup and view all the answers

    Which group of patients is indicated for surgery when diagnosed with gallstones?

    <p>Young patients with multiple gallstones</p> Signup and view all the answers

    Why is adequate Vitamin K important for patients undergoing surgery?

    <p>It contributes to proper blood coagulation.</p> Signup and view all the answers

    What potential complication can arise from drug-induced vitamin K deficiency during childbirth?

    <p>Haemorrhaging</p> Signup and view all the answers

    What condition is associated with the presence of gallstones in the common bile duct?

    <p>Choledocholithiasis</p> Signup and view all the answers

    Which of the following factors is NOT a risk factor for gallbladder cancer?

    <p>Family history of gallstones</p> Signup and view all the answers

    What should be checked before a patient undergoes surgery if they are at risk for clotting issues?

    <p>Prothrombin time</p> Signup and view all the answers

    Which treatment is recommended if a patient's prothrombin time is deranged prior to surgery?

    <p>Administer Vitamin K infusion</p> Signup and view all the answers

    In a case of elevated plasma sterols and fatty deposits, which enzyme activity is likely absent in cultured skin fibroblasts?

    <p>Sterol 27-hydroxylase</p> Signup and view all the answers

    What is a common symptom of complications arising from gallstones?

    <p>Right upper quadrant pain radiating to the back</p> Signup and view all the answers

    Which of the following is NOT a symptom that would likely arise from choledocholithiasis?

    <p>Memory loss</p> Signup and view all the answers

    What condition may result from an inflamed gallbladder due to gallstones?

    <p>Cholestasis</p> Signup and view all the answers

    What is the primary function of high-density lipoproteins (HDLs)?

    <p>Transfer cholesterol from peripheral tissues to the liver</p> Signup and view all the answers

    Why are low levels of HDL considered a risk factor for atherosclerosis?

    <p>HDL helps remove cholesterol from the bloodstream</p> Signup and view all the answers

    What is the role of the LDL receptor in cholesterol metabolism?

    <p>To mediate the uptake of LDLs by cells</p> Signup and view all the answers

    Which apoprotein is associated with high-density lipoproteins?

    <p>ApoA-1</p> Signup and view all the answers

    How are LDLs primarily taken up by cells?

    <p>Receptor-mediated endocytosis</p> Signup and view all the answers

    What distinguishes HDL from LDL in terms of their health impacts?

    <p>Higher HDL levels are associated with a lower risk of atherosclerosis</p> Signup and view all the answers

    Which statement accurately describes the relationship between VLDL and LDL?

    <p>VLDL is a precursor to LDL in the metabolism of lipoproteins</p> Signup and view all the answers

    What is one way that HDL contributes to lipid metabolism?

    <p>Transfers proteins such as apoC-II to chylomicrons</p> Signup and view all the answers

    What is the primary mechanism by which ursodeoxycholic acid relieves symptoms associated with cholestasis during pregnancy?

    <p>It protects liver cells from bile acid toxicity.</p> Signup and view all the answers

    Which type of gallstone is most commonly associated with elevated risks in patients with sickle cell anemia?

    <p>Pigment stones</p> Signup and view all the answers

    What is the likely consequence of cholestyramine treatment regarding its effects on bile salts?

    <p>Enhanced excretion of bile salts in the feces.</p> Signup and view all the answers

    Which of the following symptoms might indicate a patient has a cholesterol-rich gallstone?

    <p>Exquisitely tender pressure over the right upper abdomen.</p> Signup and view all the answers

    What secondary effect does ursodeoxycholic acid have on the placenta?

    <p>It enhances secretory function of placental trophoblast cells.</p> Signup and view all the answers

    What would be an unlikely underlying cause of elevated serum bilirubin leading to yellowish sclerae in a patient?

    <p>Defect in heme synthesis.</p> Signup and view all the answers

    In terms of treatment for cholestasis in pregnancy, which medication is noted to have minimal effect on the fetus?

    <p>Cholestyramine</p> Signup and view all the answers

    What characteristic distinguishes pigment stones from cholesterol stones?

    <p>Association with hemolytic disorders.</p> Signup and view all the answers

    Study Notes

    High-Density Lipoproteins (HDLs)

    • HDLs are known as "good cholesterol" due to their association with lower incidences of atherosclerosis.
    • VLDL and LDL are considered "bad cholesterol" and are implicated in the development of atherosclerosis.
    • HDL functions by transferring apoprotein A-1 and cholesterol from peripheral tissues back to the liver.
    • Low HDL and high LDL levels are significant risk factors for cardiovascular diseases.

    LDL Metabolism

    • LDL carries cholesteryl esters, which are taken up by cells through receptor-mediated endocytosis.
    • The LDL receptor, recognizing apoprotein B-100, facilitates this uptake process.
    • The complex of LDL and receptor forms clusters in coated pits on the plasma membrane, which invaginate to form coated vesicles.

    Cholesterol Gallstones and Pregnancy

    • Pregnancy increases the risk of cholesterol gallstones due to slowed gallbladder function and bile salt excretion.
    • Elevated estrogen and progesterone levels during pregnancy affect gallbladder motility, leading to conditions that may result in pruritus (itching) and jaundice.

    Bile Acid Formation

    • Two primary bile acids synthesized from cholesterol in the liver: cholic acid and chenodeoxycholic acid.
    • Bile salts are formed by hydroxylation, oxidation, and conjugation processes from cholesterol.
    • Bile salts aid in lipid digestion and are released from the gallbladder during meals.

    Treatment for Cholestasis in Pregnancy

    • Ursodeoxycholic acid improves hepatobiliary excretion and protects liver cells from bile acid toxicity.
    • Cholestyramine is an oral medication that binds bile salts and promotes their excretion, potentially impacting vitamin absorption.

    Gallstone Types

    • Two primary types of gallstones:
      • Pigment stones, high-risk in patients with sickle cell anemia.
      • Cholesterol stones, the most common type, associated with elevated cholesterol and decreased gallbladder motility.

    Surgical Indications for Gallstones

    • Surgery is indicated for young patients with symptomatic gallstones, gallbladder inflammation, or significant-sized stones (≥2 cm).
    • Vitamin K adequacy is crucial before surgery for proper blood clotting and should be assessed through prothrombin time.

    Choledocholithiasis (Bile Duct Stones)

    • Presence of gallstones in the common bile duct, usually originating from the gallbladder.
    • Symptoms may include elevated plasma cholesterol and cholestanol due to sterol metabolic disorders.

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    Description

    This quiz covers the fundamentals of high-density lipoproteins (HDLs) and their role in cholesterol levels. Discover why HDL is termed 'good cholesterol' in contrast to VLDL and LDL, and understand its implications for atherosclerosis risk. Test your knowledge about the key features and functions of HDLs.

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