Lipid Biochemistry USMLE Step 1 Practice Question
A 45-year-old man with a 20-year history of type 2 diabetes controlled with metformin presents with substernal chest pain. Vital signs: BP 142/88 mmHg, HR 92 bpm, RR 18, Temp 37°C, SpO2 98% on room air. Labs show triglycerides 450 mg/dL, HDL cholesterol 28 mg/dL, LDL cholesterol 95 mg/dL, and fasting glucose 185 mg/dL. EKG shows no acute ST changes. Which lipoprotein abnormality best explains his dyslipidemic pattern?
Answer choices
- ADecreased LDL receptor expression leading to accumulation of LDL particles
- BLipoprotein lipase deficiency causing chylomicronemia
- CApolipoprotein C-II deficiency preventing triglyceride clearance
- DIncreased VLDL production from hepatic overproduction of triglyceridesCorrect answer
- ECETP deficiency resulting in elevated HDL and low triglycerides
- FDecreased hepatic lipase activity impairing triglyceride hydrolysis in intermediate-density lipoproteins
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