Clinical Presentation of Hyperlipidemia - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 1 Forum

USMLE Step 1 Forum USMLE Step 1 Discussion Forum: Let's talk about anything related to USMLE Step 1 exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 11-27-2011
USMLE2011m's Avatar
USMLE Forums Veteran
 
Steps History: Step 1 Only
Posts: 277
Threads: 36
Thanked 158 Times in 95 Posts
Reputation: 168
Question Clinical Presentation of Hyperlipidemia

A 12-year-old Caucasian male is found to have turbid plasma that forms a creamy-appearing supernatant on standing. His plasma lipoprotein lipase activity measured after heparin injection is substantially lower than normal. In which of the following ways would this patient be most likely to present for medical attention?

A. Chest pain
B. Abdominal pain
C. Tendon xanthomas
D. Xanthelasmas
E. Mental retardation
__________________
Set your mind to it, and you will be there.
To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.
Reply With Quote Quick reply to this message
The above post was thanked by:
Glomerulus (11-27-2011)



  #2  
Old 11-27-2011
USMLE Forums Addict
 
Steps History: Step 1 Only
Posts: 154
Threads: 8
Thanked 134 Times in 62 Posts
Reputation: 144
Default

Abdominal pain due to acute pancreatitis. Is it hyperchylomicronemia?
Reply With Quote Quick reply to this message
  #3  
Old 11-27-2011
doxorubicin's Avatar
USMLE Forums Guru
 
Steps History: 1+CK+CS+3
Posts: 391
Threads: 98
Thanked 161 Times in 98 Posts
Reputation: 171
Default

B. abdominal pain 4m acute pancreatitis due to hypertriglyceridemia
supranate due 2 raised chlyomicrons
__________________
if ur ready to learn......world is ready to teach...take d leap!!
Reply With Quote Quick reply to this message
The above post was thanked by:
indigo (11-27-2011)
 
  #4  
Old 11-29-2011
USMLE2011m's Avatar
USMLE Forums Veteran
 
Steps History: Step 1 Only
Posts: 277
Threads: 36
Thanked 158 Times in 95 Posts
Reputation: 168
Correct Answer Answer iss...

Explanation:
Dietary lipids are transported to the peripheral tissues as chylomicrons, at which point they are hydrolyzed by lipoprotein lipase, releasing triglycerides. Lipoprotein lipase deficiency is a rare disorder that results in increased concentrations of serum chylomicrons. The body is unable to clear dietary lipid loads due to the defective hydrolysis of triglycerides in chylomicrons.
Patients present in childhood with marked hyperlipidemia, pancreatitis (abdominal pain) lipemia retinalis, eruptive skin xanthomas (small yellowish papules surrounded by erythema that occur mainly on extensor surfaces of extremities) and hepatosplenomegaly. The risk of pancreatitis is significantly increased with serum triglyceride concentrations above 1000 mg/dL.
In normal individuals heparin releases endothelium-bound lipases, encouraging the clearance of triglycerides from the circulation. In patients with lipoprotein lipase deficiency, heparin-induced lipoprotein lipase activity is significantly reduced.
(Choices A, C, D) Low-density lipoprotein (LDL) is composed predominantly of cholesterol. The main mechanism by which LDL is cleared from the circulation is by “receptor-mediated uptake” by the liver. Defects in the LDL receptor lead to hypercholesterolemia. Individuals heterozygous for the defective LDL receptor gene have an LDL receptor density of about 50% normal. Serum LDL in these individuals ranges from 200-400 mg/dL. Individuals homozygous for the defect have LDL receptor activity that is less than 2% of normal, with dramatically elevated of LDL concentrations.
Patients with hypercholesterolemia are at high risk for accelerated coronary artery disease. Those with the homozygous defect may present at a very young age. (In contrast, patients with lipoprotein lipase deficiency are not usually at increased risk for premature coronary artery disease making chest pain an unlikely presentation for the patient in the vignette.) Clinically patients with defective LDL receptors have tubular xanthomas, which are nodular lipid deposits in the tendons (most often seen in the Achilles and elbow tendons). Tubular xanthomas are the hallmark of familial hypercholesterolemia. Some patients also have xanthelasma and arcus cornea.

Educational Objective:
Abdominal pain due to acute pancreatitis is the most likely presentation for hyperchylomicronemia (hypertriglyceridemia). Patients with this disorder are not usually at increased risk for premature coronary artery disease. Skin xanthomas may be present in hypertriglyceridemia, but tubular/tendon xanthomas and xanthelasmas are present with hypercholesterolemia (high LDL).
__________________
Set your mind to it, and you will be there.
To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.
Reply With Quote Quick reply to this message
The above post was thanked by:
alankritataneja (07-28-2015), mis.med88 (08-28-2012), zainsyed (02-02-2014)



Reply

Tags
Biochemistry-, Cardiovascular-, Clinical-Signs, Pathology-, Step-1-Questions

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
Classify this Hyperlipidemia USMLE2011m USMLE Step 1 Forum 4 08-04-2011 11:29 AM
Hyperlipidemia Vitamin A toxicity! donofitaly USMLE Step 1 Forum 3 05-21-2011 12:13 AM
DiGeorge syndrome presentation step1an USMLE Step 1 Forum 20 08-27-2010 02:33 AM
Pain and Presentation ALittleTeaPot USMLE Step 1 Forum 0 07-23-2010 02:29 PM
1st step in pathogenesis of atherosclerosis caused by hyperlipidemia lemontea88 USMLE Step 1 Forum 3 01-01-2010 06:09 PM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)