Lipid Biochemistry USMLE Step 1 Practice Question
A 42-year-old woman with systemic lupus erythematosus on chronic prednisone develops acute chest pain. Vital signs show BP 145/92 mmHg, HR 102/min, RR 18/min, temp 37°C, SpO2 98%. EKG reveals ST elevation. Laboratory studies show prolonged aPTT, false-positive RPR, LDL 180 mg/dL, HDL 28 mg/dL, and negative antiphospholipid antibodies. Which mechanism best explains her premature atherosclerosis and thrombotic complications?
Answer choices
- ACorticosteroids directly increase hepatic HMG-CoA reductase expression
- BLupus anticoagulant increases HDL catabolism exclusively
- CChronic corticosteroid use induces apolipoprotein B mutations
- DSLE causes primary lipoprotein lipase deficiency
- EAntiphospholipid antibodies impair apolipoprotein-mediated LDL receptor recognitionCorrect answer
- FPrednisone inhibits lipoprotein(a) clearance by downregulating hepatic scavenger receptors
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