Flashcards in Lipid lab diagnositcs questions Deck (5):
After finding high lipid concentrations in the serum, what tests would you employ to confirm or exclude the secondary causes of hyperlipidemia?
Cushing's syndrome, ACTH and Cortisol levels
Diabetes: Insulin levels and glucose levels.
Nephrotic syndrome: Albuminuria and Proteinuria
Cholestasis: Serum LPX, Urine Conjugated Bilirubin, cB, and very decreased or Absent Urine Urobilinogen UGB.
Alcoholism, fatty liver, intoxication.
The laboratory parameters of a male having normal blood pressure, BMI 23 kg/m2 are:
serum TG: 1.5 mmol/l
serum LDL-cholesterol: 4.4 mmol/l
serum CRP: 5 mg/l
What is the risk of CHD for this person? What are the risk factors of atherosclerosis?
BMI normal range is 18.5 - 25 kg/m2
(I didn't get fat til I was 25)
Serum TG normal range 0.8-1.7 mM
Serum LDL cholesterol range < 3.4 mM
Total cholesterol range 3.6-5.2 mM
Serum CRP range: 1-8 mg/L BUT, anything over 3mg/L is considered low grade inflammation
He has type 2a hyperlipidemia with elevated LDL cholesterol, but normal TG levels. Along with low grade inflammation.
The risk for CHD and atherosclerosis is HIGH.
Non-modifyable: Age, Male gender, Post menopause, and Family history
Hyper coagulative states
Chlamydia Herpes, other intracellular infections.
A 45 year old man has the following parameters:
waist circumference: 110 cm
BP: 140/90 mmHg
HDLC: 0.9 mmol/l
fasting blood glucose: 6.3 mmol/l
What is your opinion about the risk of CHD for this person?
Waist larger than 100cm (40 inches)
HDL cholesterol is below 1.0 mM
Impaired Fasting Glucose
Very high risk of CHG, and is also at risk for Type 2 diabetes. Metabolic syndrome is sometimes classified as pre-T2DM.
A 35 year old man wanted to be screened for possible ischemic heart disease because his father died early from a heart attack. The patient was not obese and was a nonsmoker.
On examination his blood pressure was normal and the only abnormality was tendon xanthomata arising from the Achilles tendons. An ECG taken at rest was normal but ischemic changes developed on exercise.
Fasting lipids: serum cholesterol 8.7 mmol/l,
triglyceride 1.1 mmol/l.
What is the most likely diagnosis and how can you confirm it?
Total cholesterol is above 5.2 mM and is considerably high.
TAGs are normal.
Diagnosis: Familial hypercholesterinemia,
Test serum LDL levels,
Test OTHER family members for serum lipid levels as well.
Genetic testing on LDL receptor