Question

Using Figure 20-7 in your text evaluate the following situation. You have been invited toattend Dr. John Ambrose’s (Professor of Medicine, UCSF; Director of Cardiology,Community Regional Medical Center; Chief of Cardiology, UCSF Fresno; Program Director, UCSF Fresno Cardiovascular Fellowship) lecture on “Sudden Cardiac Deathand Cardiac Arrest.” You were one of the lucky guests that were also invited to thebreakfast which consisted of scrambled eggs, biscuits and gravy, bacon and sausage, fresh fruit, coffee, juice and hot tea. Several hours later you are admitted to UCSF’sMedical Center with severe abdominal pain. The attending physician tells you that yourblood has the appearance of “creamed tomato soup,” and upon analysis it also containslarge amounts of chylomicrons. As a student, well-versed in fatty acid catabolism, you already know the diagnosis. What is it? How can you prevent this condition in the future?

Dietary fat Endogenous Dietary cholesterol cholesterol HDL Liver Bile acids LDL Extrahepatic cells Gallbladder IDL Adipose tissue ● VLDL Large lipid droplets Stomach lipoproteirn pase Cholesterol-rich Small intestine chylomicron remnants Micelles Triacylglycerol Intestinal epithelial ell Muscle cells Blood vessel Exogenous pathway Endogenous pathway ly m Fatty acids Intestinal lymph Chylomicrons FIG. 20-7 Plasma triacylglycerol and cholesterol transport in humans

Answer 1

1.Chylomicronemia is the condition. In Individuals with normal metabolism, chylomicrons are cleared from plasma within 3-4hours of eating.

2 The main stay of therapy for patients with chylomicronaemia is a diet low in fat. Control of lifestyle factors and other secondary causes hypertriglyceridaemia are also important for patients with chylomicronaemia. These factors and causes include avoidance of alcohol and obesity as well as medications known to worsen hyoertriglyceridaemia such as exogenous estrogens, corticosteroid, retinoids, Beta blockers, thiazide diuretics, bile acid resins and introducing oils that are high in medium -chain triglycerides ,such as coconut oil, has had some success in patients with Chylomicronaemia.