Lipid Biochemistry USMLE Step 1 Practice Question
A 62-year-old woman undergoing chemotherapy for breast cancer presents with acute dyspnea and pleuritic chest pain. Vital signs show BP 138/82, HR 102, RR 22, temp 37.8°C, SpO2 88%. Serum triglycerides are 2800 mg/dL with amylase 450 U/L. Chest imaging reveals bilateral pulmonary infiltrates. She denies recent alcohol use. Which mechanism best explains the markedly elevated triglycerides in this chemotherapy-induced acute pancreatitis?
Answer choices
- AReduced hepatic VLDL clearance due to decreased lipoprotein lipase activity from pancreatic inflammationCorrect answer
- BAcute onset hepatic steatosis reducing apoB-100 synthesis
- CChemotherapy-induced inhibition of HMG-CoA reductase reducing lipolysis
- DAcute hyperglycemia stimulating VLDL particle number synthesis
- EIncreased intestinal absorption of dietary fat leading to chylomicronemia
- FChemotherapy-mediated suppression of adipose tissue hormone-sensitive lipase preventing triglyceride mobilization from storage
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