Lipid Biochemistry USMLE Step 1 Practice Question
A 51-year-old man with type 2 diabetes mellitus and metabolic syndrome presents with BP 148/92 mmHg, HR 88/min, and denies chest pain. Fasting laboratory studies show triglycerides 280 mg/dL, HDL cholesterol 32 mg/dL, and LDL cholesterol 156 mg/dL. Apolipoprotein B is elevated. VLDL particles are small and dense on lipid analysis. He takes metformin but denies statin use. Which metabolic disturbance in lipid metabolism best explains these findings?
Answer choices
- AIncreased hepatic apoB-100 synthesis with reduced clearance of VLDL particlesCorrect answer
- BDefective hepatic cholesterol esterification
- CDecreased intestinal absorption of dietary triglycerides
- DImpaired hydrolysis of triglycerides by adipose tissue lipoprotein lipase
- EPrimary deficiency of hepatic triglyceride lipase
- FIncreased peripheral lipolysis with enhanced free fatty acid uptake by the liver
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