Blood lipids

1. What is left of VLDLs after they pass through muscle or tissue and their TGs are hydrolysed to free fatty acids by lipoprotein lipase and taken up by the aforementioned cells (3)
2. This emulsifies fat into smaller droplets (4, 5)
3. This is what HMG CoA Reductase Inhibitors are also known as (7)
4. An example of a PCSK9 inhibitor (PCSK9 promotes the uptake of LDL receptors in the liver, causing them to degrade so uptake of lipid is reduced). It is used as an additive as it is very expensive (10)
5. A drug class which increases production of lipoprotein lipase and HDL, reduces production of VLDLs, reduces TG levels and increases LDL uptake. Examples: benzafibrate and gemfibrozil. Side effect of myositis (8)
6. This enzyme breaks down fat into triglycerides and cholesterol esters (6)
9. A major side effect of statins (8)

2. These are drugs which are used to bind to bile acids so they cannot emulsify fats - both the fat and the bile acids are lost in the stool. There is less cholesterol absorbed and increased expression of LDL receptors. GI side effects. Not first line (4, 4, 6)
7. This can be given to make eicosanoids which are less likely to cause clotting, therefore it can be used to improve survival after MI. Impact on lipids is not relevant (4, 3)
10. The lipoprotein which takes up the TGs and esters which are released from the hepatocytes in the endogenous liver pathway (4)

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