Secondary Causes of Dyslipidemia Flashcards

In patients with type 2 diabetes mellitus, which lipid abnormality is MOST characteristic?

Answer: Elevated triglycerides, low HDL-C, and small dense LDL particles

T2DM classically produces the 'diabetic dyslipidemia' triad: elevated triglycerides, low HDL-C, and a predominance of small dense LDL particles.

Acromegaly most commonly causes which type of dyslipidemia?

Answer: Hypertriglyceridemia with or without reduced HDL-C

Excess growth hormone in acromegaly promotes lipolysis and hepatic VLDL production, resulting primarily in hypertriglyceridemia.

A 35-year-old woman taking oral contraceptives (ethinyl estradiol/progestin) has TG of 680 mg/dL. Which mechanism explains the OCP effect?

Answer: Estrogen inhibits LPL activity and stimulates hepatic VLDL production

Estrogen in oral contraceptives stimulates hepatic VLDL synthesis and may inhibit lipoprotein lipase, particularly raising triglycerides in genetically susceptible individuals.

Which autoimmune condition is associated with secondary dyslipidemia due to production of autoantibodies against lipoprotein lipase?

Answer: Systemic lupus erythematosus

SLE can produce anti-LPL antibodies, impairing triglyceride-rich lipoprotein clearance and causing severe hypertriglyceridemia.

Which atypical antipsychotic is most strongly associated with secondary hypertriglyceridemia and metabolic syndrome?

Answer: Clozapine

Clozapine (and olanzapine) have the highest metabolic liability among atypical antipsychotics, causing weight gain, hypertriglyceridemia, and new-onset diabetes.

A patient with untreated hypothyroidism has LDL-C of 195 mg/dL. After levothyroxine therapy achieves euthyroid state, LDL-C falls to 140 mg/dL. What was the primary mechanism of the initial elevated LDL?

Answer: Reduced bile acid synthesis and decreased cholesterol excretion

Hypothyroidism reduces LDL receptor expression and bile acid synthesis, impairing LDL clearance and cholesterol catabolism, resulting in elevated LDL-C.

Isotretinoin (13-cis retinoic acid) used for acne causes which lipid change most frequently?

Answer: Hypertriglyceridemia, sometimes severe

Isotretinoin commonly elevates triglycerides (in 25% of patients) and can rarely precipitate pancreatitis-level hypertriglyceridemia.