Lipid Biochemistry USMLE Step 1 Practice Question
A 29-year-old woman with systemic lupus erythematosus presents with fatigue and edema after 6 weeks of high-dose prednisone (60 mg daily) for lupus nephritis. Vital signs: BP 148/92 mmHg, HR 88 bpm, RR 16, Temp 37°C, SpO2 98%. Lipid panel shows total cholesterol 280 mg/dL and LDL cholesterol 210 mg/dL; urinalysis shows persistent proteinuria. She denies chest pain or dyspnea. Which mechanism best explains the corticosteroid-induced hypercholesterolemia?
Answer choices
- AReduced activity of hepatic triglyceride lipase
- BUpregulation of HMG-CoA reductase and increased hepatic cholesterol synthesisCorrect answer
- CEnhanced reverse cholesterol transport by HDL
- DInhibition of apolipoprotein B synthesis
- EDecreased expression of LDL receptors on hepatocytes
- FIncreased conversion of VLDL to LDL through enhanced lipoprotein lipase activity
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