Lipid Biochemistry USMLE Step 1 Practice Question
A 52-year-old man with type 2 diabetes and hypertension presents with BP 148/92 mmHg, HR 88/min, and truncal obesity. Laboratory studies show fasting glucose 156 mg/dL, triglycerides 350 mg/dL, HDL cholesterol 28 mg/dL, and LDL cholesterol 165 mg/dL. He denies smoking and takes metformin monotherapy. Which of the following best describes the primary defect in lipoprotein metabolism underlying his metabolic syndrome?
Answer choices
- APrimary defect in apolipoprotein E synthesis impairing remnant particle clearance
- BInsulin resistance leading to increased hepatic VLDL secretion and decreased HDL catabolismCorrect answer
- CPrimary hyperproduction of chylomicrons from excessive intestinal fat absorption
- DGenetic mutation in the CETP gene causing impaired cholesterol ester transfer
- EDeficiency of lecithin-cholesterol acyltransferase preventing reverse cholesterol transport
- FPrimary defect in lipoprotein lipase activity reducing triglyceride hydrolysis and clearance of chylomicrons
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