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NBME 20 Answers

nbme20/Block 4/Question#48 (38.3 difficulty score)
A 24-year-old man comes to the emergency ...
Lipoprotein lipase🔍,📺

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submitted by hayayah(1101),
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P.t hsa Failmila iseds.pmliiayd eyTp ccnr—iyoeoyi.HmalrhmpeI

estefanyargueta  Lipoprotein lipase: degradation of TGs circulating in chylomicrons and VLDLs. +2  
breis  FA 2019 pg 94 +4  

submitted by blanee1380(2),

Very large increase in TGs causes pancreatitis.
Deficiencies in:

Apo B-100: Type II familial hypercholesterolemia, increases mostly LDL which increases cholesterol

Apo E: Decreased remnant uptake, which increases mostly chylomicrons and VLDL, but it's milder so no pancreatitis.

HSL: deficiency would decrease TGs, not increase

LDL receptor: Type II hypercholesterolemia also

So lipoprotein lipase deficiency is the anser, which causes large increase in chylomicrons and TGs, leading to pancreatitis and has a creamy layer in supernatant.

submitted by pg32(174),
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Cna yonnae lneapxi yhw the sepail netncirnootca si so ihhg fi erteh is an uisse hwti PLL in oneroayiycelp?ihhmmrc

garima  due to pancreatitis +5  
neovanilla  ELI5? +  
suckitnbme  @neovanilla Type 1-hyperchylomicronemia has increased risk of pancreatitis +  
makingstrides  I don't understand why this isn't hypertriglyceridemia because this also causes acute pancreatitis. Maybe because overproduction of VLDL isn't an answer? +