PATHO KNOWLEDGE CHECK
MODULE 2
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CC: “I have been having terrible chest and arm pain for the past 2 hours and I think I am having a heart
... [Show More] attack.”
HPI: Mr. Hammond is a 57-year-old African American male who presents to the Emergency Department with a chief complaint of chest pain that radiates down his left arm. He states that he started having pain several hours ago and says the pain “it feels like an elephant is sitting on my chest”. He rates the pain as 8/10. Nothing has made the pain better or worse. He denies any previous episode of chest pain. Denies nausea, dyspnea, or lightheadedness. He was given 0.4 mg nitroglycerine tablet sublingual x 1 which decreased, but not stopped the pain.
Lipid panel reveals Total Cholesterol 324 mg/dl, high density lipoprotein (HDL) 31 mg/dl, Low Density Lipoprotein (LDL) 122 mg/dl, Triglycerides 402 mg/dl, Very Low-Density Lipoprotein (VLDL) 54 mg/dl
His diagnosis is an acute inferior wall myocardial infarction.
1 of 2 Questions:
Why is HDL considered the “good” cholesterol?
Selected Answer: Coronary heart disease is the leading killer of Americans. It is caused by atherosclerosis, which is the narrowing of the coronary arteries due to formation of lipid laden lesions. The narrowed arteries hinders blood flow and can result in destruction of the heart tissue due to inadequate supply of oxygen, a myocardial infarction. High density lipoproteins (HDL) is considered the good cholesterol because it does many things to keep the body functioning normally. HDL moves excess cholesterol from tissues and returns it to the liver. There it binds to liver receptors and is eliminated from the body as bile or it is converted to cholesterol containing steroids. HDL can remove excess cholesterol from arterial walls, protect LDL from oxidation, preserve endothelial function, promotes antiinflammatory and antithrombotic effects. HDL progresses into 3 subtypes, and the smaller HDL3 molecule is is the most protective in preventing atherosclerosis. If the levels of HDL are low, they are a strong indicator of coronary risk. Positive family history is a risk factor of heart disease.
Correct Answer:
HDL is considered the good cholesterol because it collects excess cholesterol in the body cells and transports it to the liver where it is excreted in the body cells and transports it to the liver where it is excreted in the body. HDL carries 20-25% of total plasma cholesterol.
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