Clinical Chemistry Test Bank Chapter 23 (Lipids, lip-Oproteins, apolipoproteins, and Other Cardiac Risk Factors)

1- A 46-year-old man visits his physician complaining of fatigue and chest pains. His family history reveals that his father and grandfather both died of heart attacks at the age of 50.Laboratory results indicated elevated total cholesterol, elevated low-density lipoprotein (LDL), and normal triglyceride. He is eventually diagnosed with familial hypercholesterolemia and atherosclerosis. What is the likely cause??




... Answer is A)
2- The lipoprotein with the smallest diameter and that has a 50:50 lipid: lipoprotein ratio is the:?




... Answer is C)
3- In the small intestine, _____ is (are) solubilized by emulsification to form micelles.?




... Answer is B)
4- Cholesterol is esterified to form a cholesteryl ester by acylcholesterol acyltransferase in the cell. In the circulation, cholesteryl esters are formed by the action of which one of the following enzymes??




... Answer is C)
5- Recognized abnormalities of fatty acid catabolism associated with uncontrolled diabetes mellitus include the development of ketone formation. This ketosis is caused by:?




... Answer is D)
6- Why would high sensitivity C-reactive protein (CRP) be an indicator of potential coronary heart disease (CHD)??




... Answer is A)
7- A 6-year-old girl has complained about painful urination and is taken to her pediatrician. There is no family history of CHD or any lipid abnormalities. After a fasting blood specimen and urine specimen are obtained, laboratory findings are as follows (healthy reference intervals are in parentheses): serum albumin 1.8 g/dL (3.5 to 5.5 g/dL), total serum cholesterol 200 mg/dL (<170 mg/dL), LDL cholesterol 130 mg/dL (<110 mg/dL), serum triglyceride 250 mg/dL (<200 mg/dL), serum urea nitrogen 20 mg/dL (7 to 18 mg/dL), heavy urine protein (normal is negative), and 1+ urine blood (normal is negative). All other laboratory values were normal. These findings are most compatible with:?




... Answer is B)
8- What distinguishes lipoprotein (a), or Lp (a), from LDL??




... Answer is C)
9- An individual visits a physician, who notes that the patient has splenomegaly, enlarged and orange-colored tonsils, and tingling feelings in the extremities, indicating peripheral neuropathy. Upon examination of the blood smear for a white blood cell differential, many foamy-appearing cells were noted. Normal triglyceride and total cholesterol values were noted; however, a marked decrease of HDL was also noted. What is the name of this disorder??




... Answer is B)
10- An individual visits his physician with splenomegaly, enlarged and orange-colored tonsils, and tingling feelings in the extremities, indicating peripheral neuropathy. Upon examination of the blood smear for a white blood cell differential, many foamy-appearing cells were noted. Normal triglyceride and total cholesterol values were noted; however, a marked decrease of HDL was also noted. What is the cause of this disorder??




... Answer is D)
11- The lipoprotein that, because it is considered proatherogenic, is often measured by the laboratory to assess the likelihood of CHD in an individual with normal lipid values but a strong family history of cardiovascular disease is:?




... Answer is C)
12- The apolipoprotein that functions to facilitate uptake of chylomicron remnants by the liver, is involved in dysbetalipoproteinemia, and that has an isoform associated with the risk of Alzheimer disease development is apo:?




... Answer is A)
13- There is an inverse relationship between which of the following cholesterol-containing lipoproteins and increased risk of CHD??




... Answer is D)
14- In the 3-step assay for determination of cholesterol concentration, cholesteryl esters must be cleaved by an enzyme. This hydrolytic cleavage forms:?




... Answer is C)
15- In the 3-step assay for determination of cholesterol concentration, cholesteryl esters must be cleaved by which of the following enzymes for the initial step to occur??




... Answer is D)
16- The difference between traditional HDL cholesterol assays and the direct homogeneous assay is that:?




... Answer is A)
17- Cholesterol plays a role in all of the following except:?




... Answer is A)
18- The polar amphipathic lipid that forms a surface coating around a core of cholesterol esters and triglyceride in a lipoprotein is:?




... Answer is C)
19- The class of lipid that is derived from fatty acids and that alters blood pressure by its action on arterial smooth muscle cells is:?




... Answer is D)
20- Essential fatty acids are:?




... Answer is B)
21- What is (are) the principal apo B-100 containing lipoprotein (s) secreted by the liver??




... Answer is B)
22- A 9-year-old boy was referred by his dermatologist for a lipid evaluation after the boy developed what appeared to be a raised yellowish rash over his palms and elbows. The boy had no previous history of heart problems and no family history of any coronary disorders. However, when he was 8, he did have two acute attacks of pancreatitis and abdominal pain. His lipid workup is as follows (specimen was a fasting blood draw): triglyceride 3200 mg/dL (normal <200 mg/dL), total cholesterol 190 mg/dL (normal <200 mg/dL), glucose 160 mg/dL (normal 60 to 110 mg/dL).His HDL concentration was in normal range, but LDL was elevated. Specimen was grossly lipemic. What is the likely cause of these symptoms??




... Answer is A)
23- Which one of the following lipid metabolic pathways involves the removal of excess cellular cholesterol from cells and returning it to the liver for excretion??




... Answer is D)
24- You have received two blood samples, one in a sodium citrate tube for coagulation studies and the other in an oxalate tube for glucose analysis from a patient diagnosed with diabetes mellitus. This patient's physician contacts you to request that lipid and lipoprotein analyses be added to the previous studies. What would be the best blood specimen for lipoprotein analyses and why??




... Answer is D)
25- In addition to unesterified cholesterol, what is the second constituent of the outer coating of a lipoprotein, labeled with a question mark and represented by a white circle in this diagram??




... Answer is B)
26- The Friedewald formula is used to indirectly determine the concentration of which one of the following??




... Answer is D)
27- Approximately one-third of the daily production of circulating cholesterol is converted in the liver to form:?




... Answer is C)
28- The high-sensitivity detection method for CRP (hs-CRP) used to detect low concentrations of this protein is typically a (n):?




... Answer is C)
29- The major component of a lipoprotein that functions to maintain the structural integrity of the lipoprotein complex and that modulates the activity of the enzymes that act on lipoproteins is the:?




... Answer is A)
30- In the intracellular-cholesterol transport pathway of lipoprotein metabolism, cholesterol homeostasis is maintained through control of cellular uptake. The LDL cell surface receptor delivers lipoprotein particles containing cholesteryl esters to lysosomes. The apolipoprotein that is recognized by this receptor is apo:?




... Answer is C)
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