Lipid metabolism disorders, classification, complications

Big picture

Lipid metabolism disorders are abnormalities of plasma lipoproteins, mainly involving cholesterol, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and lipoprotein remnants.

For the Internal Medicine exam, think clinically:

High LDL cholesterol
        ↓
Atherosclerosis
        ↓
Myocardial infarction, stroke, peripheral arterial disease

Very high triglycerides
        ↓
Chylomicronemia / severe hypertriglyceridemia
        ↓
Acute pancreatitis

Familial lipid disorder
        ↓
Early disease, xanthomas, family history

The examiner usually wants you to know:

1. Classification of dyslipidemias
2. Primary vs secondary causes
3. Fredrickson hyperlipoproteinemia classification
4. Complications: atherosclerosis and pancreatitis
5. Physical signs: xanthomas, xanthelasma, corneal arcus, lipemia retinalis

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