Diagnosis & Classification of Dyslipidemia Flashcards

A patient with nephrotic syndrome is most likely to exhibit which dyslipidemia pattern?

Answer: Elevated LDL-C and VLDL with reduced HDL-C

Nephrotic syndrome causes a broad dyslipidemia with elevated LDL-C and VLDL (due to increased hepatic lipoprotein synthesis) and low HDL-C due to urinary loss of apoA-I.

Eruptive xanthomas appearing suddenly over the buttocks and extensor surfaces in a young man are most consistent with severe elevation of which lipoprotein?

Answer: Chylomicrons and/or VLDL (TG > 1000 mg/dL)

Eruptive xanthomas are pathognomonic of extreme hypertriglyceridemia (TG >1000 mg/dL) due to chylomicron and/or VLDL excess causing tissue lipid deposition.

Which condition is characterized by absent or severely reduced apolipoprotein B-containing lipoproteins and is diagnosed in infancy with fat malabsorption?

Answer: Abetalipoproteinemia

Abetalipoproteinemia (MTP gene mutations) prevents assembly and secretion of all apoB-containing lipoproteins, causing fat malabsorption, acanthocytosis, and neurological complications.

When is a non-fasting lipid panel preferred over a fasting panel for cardiovascular risk assessment?

Answer: For initial screening and routine risk assessment in most adults

Current ACC/AHA and ESC guidelines support non-fasting lipid measurement for routine cardiovascular risk screening, as non-fasting LDL-C correlates well with ASCVD risk.

Palmar xanthomas (xanthoma striata palmaris) are pathognomonic for which dyslipidemia?

Answer: Familial dysbetalipoproteinemia (Type III)

Yellow deposits in the palmar creases (xanthoma striata palmaris) are a hallmark of Type III hyperlipoproteinemia caused by IDL/remnant accumulation.

According to the Simon Broome criteria for FH, a 'definite FH' diagnosis in an adult requires LDL-C above what threshold plus tendon xanthomas or DNA evidence?

Answer: 210 mg/dL

Simon Broome criteria define definite FH as LDL-C >4.9 mmol/L (~190 mg/dL in some sources, but the UK criteria use 210 mg/dL for adults) plus tendon xanthomas or an LDLR/APOB mutation.

A patient is found to have borderline high TG (150–199 mg/dL) at a routine screening. Which secondary cause should be ruled out first given its high prevalence?

Answer: Poorly controlled type 2 diabetes mellitus

Insulin resistance and poorly controlled diabetes are by far the most prevalent secondary causes of elevated TG, and fasting glucose/HbA1c should be checked early in the workup.