Lipid Biochemistry USMLE Step 1 Practice Question
A 28-year-old woman at 20 weeks gestation presents with severe epigastric pain and nausea. Vital signs show BP 128/82 mmHg, HR 102 bpm, RR 18, temp 37.2°C. Serum triglycerides are 1,850 mg/dL (normal <150 mg/dL); total cholesterol is elevated. She denies alcohol use. She has a known history of familial lipoprotein lipase deficiency. Which of the following best explains the dramatically elevated triglyceride level during pregnancy?
Answer choices
- APregnancy-induced suppression of hepatic cholesterol synthesis pathways
- BEstrogen-induced increase in VLDL production exceeding impaired lipolytic clearanceCorrect answer
- CLipoprotein lipase gene expression upregulation in response to fetal growth
- DIncreased intestinal absorption of dietary triglycerides during pregnancy
- EFetal demands for cholesterol overwhelming maternal lipid metabolism
- FPlacental production of apolipoprotein C-II leading to enhanced triglyceride synthesis
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