LIPID AND LIPOPROTEIN DISORDERS MCQs – 40 MCQs | Kenya MBChB

40 Year 3: Endocrine and Metabolic Pathology exam questions on LIPID AND LIPOPROTEIN DISORDERS MCQs for medical students. Includes MCQs, answers, explanations a

This MCQ set contains 40 questions on LIPID AND LIPOPROTEIN DISORDERS MCQs in the Year 3: Endocrine and Metabolic Pathology unit. Each question includes the correct answer and a detailed explanation for active recall and exam preparation.

Q1: Which lipoprotein is responsible for transporting dietary triglycerides from the intestines to tissues?

  1. A. VLDL
  2. B. LDL
  3. C. Chylomicrons
  4. D. HDL

Correct answer: C – Chylomicrons

Chylomicrons are the largest lipoproteins and transport dietary triglycerides from the intestines to other tissues. They are primarily involved in the transport of dietary fats.

Q2: What is the primary function of HDL cholesterol?

  1. A. Transport cholesterol to peripheral tissues
  2. B. Transport cholesterol from cells back to the liver for excretion
  3. C. Transport dietary fats from intestines
  4. D. Store triglycerides

Correct answer: B – Transport cholesterol from cells back to the liver for excretion

HDL (High-Density Lipoprotein) transports cholesterol from cells and tissues back to the liver for excretion, earning it the name "good cholesterol." High HDL levels are associated with lower cardiovascular risk.

Q3: Which enzyme is responsible for breaking down triglycerides in adipose tissue during lipolysis?

  1. A. Lipoprotein lipase
  2. B. Hormone-sensitive lipase
  3. C. Acetyl-CoA carboxylase
  4. D. Fatty acid synthase

Correct answer: B – Hormone-sensitive lipase

Hormone-sensitive lipase breaks down triglycerides into glycerol and free fatty acids, primarily in adipose tissue during lipolysis in response to hormonal signals.

Q4: What happens to VLDL as it loses triglycerides?

  1. A. It becomes chylomicrons
  2. B. It transforms into LDL
  3. C. It becomes HDL
  4. D. It is excreted

Correct answer: B – It transforms into LDL

VLDL (Very-Low-Density Lipoprotein) carries triglycerides from the liver to tissues. As VLDL loses triglycerides through lipoprotein lipase action, it transforms into LDL.

Q5: Which hormone promotes lipogenesis and inhibits lipolysis?

  1. A. Glucagon
  2. B. Epinephrine
  3. C. Insulin
  4. D. Cortisol

Correct answer: C – Insulin

Insulin promotes lipogenesis (fat synthesis) and inhibits lipolysis (fat breakdown), while glucagon and epinephrine have opposite effects, stimulating lipolysis.

Q6: What is the genetic defect in familial hypercholesterolemia?

  1. A. Deficiency of lipoprotein lipase
  2. B. Mutation in LDL receptor genes
  3. C. Apolipoprotein E defect
  4. D. HDL receptor mutation

Correct answer: B – Mutation in LDL receptor genes

Familial hypercholesterolemia results from mutations affecting LDL receptors, leading to elevated LDL cholesterol. Heterozygous form has one mutated allele; homozygous has both alleles mutated.

Q7: Which clinical sign consists of yellowish nodules commonly found on the Achilles tendon in hypercholesterolemia?

  1. A. Xanthelasma
  2. B. Tendon xanthomas
  3. C. Eruptive xanthomas
  4. D. Arcus senilis

Correct answer: B – Tendon xanthomas

Tendon xanthomas are yellowish nodules on tendons, commonly around the Achilles tendon or hands, characteristic of severe hypercholesterolemia, particularly familial hypercholesterolemia.

Q8: What condition can severe hypertriglyceridemia lead to?

  1. A. Stroke
  2. B. Acute pancreatitis
  3. C. Hypothyroidism
  4. D. Renal failure

Correct answer: B – Acute pancreatitis

Severe hypertriglyceridemia can lead to acute pancreatitis, presenting with abdominal pain, nausea, and vomiting. This is a serious complication of markedly elevated triglyceride levels.

Q9: What is lipemia retinalis?

  1. A. Fatty deposits on eyelids
  2. B. Milky appearance of retina due to extremely elevated triglycerides
  3. C. Vision loss from cholesterol
  4. D. Retinal hemorrhage

Correct answer: B – Milky appearance of retina due to extremely elevated triglycerides

Lipemia retinalis is a rare condition where triglycerides are extremely elevated (usually 2000-4000 mg/dL), leading to a milky appearance of the retinal vessels during eye examination.

Q10: Which statin is commonly used to lower LDL cholesterol?

  1. A. Fenofibrate
  2. B. Atorvastatin
  3. C. Ezetimibe
  4. D. Niacin

Correct answer: B – Atorvastatin

Atorvastatin is a statin (HMG-CoA reductase inhibitor) that is the primary treatment for lowering LDL cholesterol. Other statins include simvastatin and rosuvastatin.

Q11: What is the primary metabolic pathway for fatty acid breakdown in mitochondria?

  1. A. De novo lipogenesis
  2. B. Beta-oxidation
  3. C. Lipolysis
  4. D. Glycolysis

Correct answer: B – Beta-oxidation

Beta-oxidation is the process where free fatty acids are transported to mitochondria and converted into acetyl-CoA, which enters the Krebs cycle for energy production.

Q12: Which apolipoprotein defect is responsible for familial dysbetalipoproteinemia?

  1. A. Apolipoprotein A1
  2. B. Apolipoprotein B
  3. C. Apolipoprotein E
  4. D. Apolipoprotein C

Correct answer: C – Apolipoprotein E

Familial dysbetalipoproteinemia results from genetic defects in apolipoprotein E, leading to elevated IDL (Intermediate-Density Lipoprotein) cholesterol and premature atherosclerosis.

Q13: What is the characteristic clinical finding of palmar xanthomas?

  1. A. Found in familial hypertriglyceridemia
  2. B. Associated with familial dysbetalipoproteinemia
  3. C. Seen only in children
  4. D. Present in hypothyroidism

Correct answer: B – Associated with familial dysbetalipoproteinemia

Palmar xanthomas (yellowish deposits on the palms) along with tuberous xanthomas on elbows and knees are characteristic of familial dysbetalipoproteinemia.

Q14: Which medication class primarily lowers triglycerides and sometimes raises HDL?

  1. A. Statins
  2. B. Fibrates
  3. C. Bile acid sequestrants
  4. D. PCSK9 inhibitors

Correct answer: B – Fibrates

Fibrates (such as fenofibrate and gemfibrozil) are primarily used to lower triglycerides and can sometimes raise HDL cholesterol levels.

Q15: What is Type I hyperlipoproteinemia characterized by?

  1. A. Elevated LDL only
  2. B. Elevated chylomicrons due to lipoprotein lipase deficiency
  3. C. Elevated HDL
  4. D. Low triglycerides

Correct answer: B – Elevated chylomicrons due to lipoprotein lipase deficiency

Type I hyperlipoproteinemia is characterized by elevated chylomicrons due to lipoprotein lipase deficiency, leading to severe hypertriglyceridemia.

Q16: When do heart attacks typically occur in heterozygous familial hypercholesterolemia?

  1. A. In childhood
  2. B. Before age 50 years
  3. C. After age 70 years
  4. D. Never occur

Correct answer: B – Before age 50 years

In heterozygous familial hypercholesterolemia, early-onset cardiovascular disease with heart attacks or strokes often occurs at a younger age, typically before 50 years.

Q17: What is the mechanism of action of ezetimibe?

  1. A. Inhibits HMG-CoA reductase
  2. B. Reduces cholesterol absorption in the intestine
  3. C. Increases bile acid excretion
  4. D. Activates lipoprotein lipase

Correct answer: B – Reduces cholesterol absorption in the intestine

Ezetimibe is a cholesterol absorption inhibitor that lowers LDL cholesterol by reducing cholesterol absorption in the intestine.

Q18: Which secondary condition is associated with elevated triglycerides and low HDL cholesterol?

  1. A. Hypothyroidism
  2. B. Diabetes mellitus (diabetic dyslipidemia)
  3. C. Nephrotic syndrome
  4. D. Liver cirrhosis

Correct answer: B – Diabetes mellitus (diabetic dyslipidemia)

Diabetic dyslipidemia is characterized by elevated triglycerides and low HDL cholesterol due to insulin resistance and diabetes mellitus.

Q19: What laboratory test measures Total Cholesterol, LDL, HDL, and Triglycerides?

  1. A. Complete blood count
  2. B. Lipid profile
  3. C. Liver function tests
  4. D. Renal panel

Correct answer: B – Lipid profile

A lipid profile (or lipid panel) is the standard test that measures total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides to assess lipid status.

Q20: In homozygous familial hypercholesterolemia, when do heart attacks typically occur?

  1. A. After age 60
  2. B. In childhood or adolescence
  3. C. In middle age (40-50 years)
  4. D. They don't occur

Correct answer: B – In childhood or adolescence

Homozygous familial hypercholesterolemia presents with extremely high LDL cholesterol and severe atherosclerosis, with heart attacks occurring in childhood or adolescence.

Q21: What is xanthelasma?

  1. A. Nodules on tendons
  2. B. Yellowish patches on eyelids or around the eyes
  3. C. Deposits on palms
  4. D. Ring around the cornea

Correct answer: B – Yellowish patches on eyelids or around the eyes

Xanthelasma refers to yellowish patches on the eyelids or around the eyes, which are cholesterol deposits commonly seen in hypercholesterolemia.

Q22: Which class of drugs works by binding bile acids in the intestine to lower LDL cholesterol?

  1. A. Statins
  2. B. Fibrates
  3. C. Bile acid sequestrants
  4. D. PCSK9 inhibitors

Correct answer: C – Bile acid sequestrants

Bile acid sequestrants (like cholestyramine and colesevelam) lower LDL cholesterol by binding bile acids in the intestine, forcing the liver to use cholesterol to make more bile acids.

Q23: What is the recommended duration of moderate-intensity exercise per week for lipid management?

  1. A. 30 minutes
  2. B. 60 minutes
  3. C. 150 minutes
  4. D. 300 minutes

Correct answer: C – 150 minutes

Regular physical activity of at least 150 minutes of moderate-intensity exercise per week (such as brisk walking or cycling) is recommended for improving lipid profiles.

Q24: Which lipoprotein is a transitional form between VLDL and LDL?

  1. A. Chylomicrons
  2. B. HDL
  3. C. IDL (Intermediate-Density Lipoprotein)
  4. D. Lipoprotein (a)

Correct answer: C – IDL (Intermediate-Density Lipoprotein)

IDL (Intermediate-Density Lipoprotein) is a transitional form between VLDL and LDL, involved in lipid metabolism as VLDL loses triglycerides.

Q25: What enzyme is key in lipogenesis (fatty acid synthesis)?

  1. A. Hormone-sensitive lipase
  2. B. Lipoprotein lipase
  3. C. Acetyl-CoA carboxylase
  4. D. Carnitine palmitoyltransferase

Correct answer: C – Acetyl-CoA carboxylase

Acetyl-CoA carboxylase is a key enzyme in lipogenesis, catalyzing the first committed step in fatty acid synthesis by converting acetyl-CoA to malonyl-CoA.

View on OmpathStudy