1. Elevated serum triglyceride levels are observed in all of the following conditions EXCEPT:

INI-CET EXAM -2026

Biochemistry & Nutrition

Medium

Appeared in: INI-CET EXAM -2026

Explanation

Abetalipoproteinemia is a rare autosomal recessive disorder characterized by the inability to synthesize apolipoprotein B (ApoB)-containing lipoproteins.
It is caused by mutations in the Microsomal Triglyceride Transfer Protein (MTTP) gene.
The MTTP protein is essential for loading lipids onto ApoB, forming chylomicrons in the intestine and Very-Low-Density Lipoprotein (VLDL) in the liver.
This defect blocks the secretion of triglycerides into the bloodstream, resulting in fat malabsorption and extremely low levels of plasma triglycerides and cholesterol.

Option B: Type 2 diabetes mellitus is a common cause of secondary hypertriglyceridemia. Insulin resistance leads to increased free fatty acid flux to the liver and increased hepatic synthesis and secretion of VLDL, which is rich in triglycerides.
Option C: A diet high in fructose promotes de novo lipogenesis in the liver. The liver rapidly converts excess fructose into triglycerides, which are then packaged into VLDL particles and released into the blood, causing elevated triglyceride levels.
Option D: Nephrotic syndrome causes significant proteinuria, especially loss of albumin. In response to low plasma oncotic pressure, the liver ramps up the synthesis of various proteins, including lipoproteins (like VLDL). This compensatory overproduction leads to hyperlipidemia, including elevated serum triglycerides.

Clinical Relevance

Nursing practice connection: Knowing Pathophysiology of dyslipidemia and causes of abnormal serum triglyceride levels helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Understanding the causes of dyslipidemia is crucial for nurses in assessing cardiovascular risk and managing patients with metabolic, endocrine, and renal disorders.
Nurses play a key role in patient education regarding diet and lifestyle modifications for managing hypertriglyceridemia, such as reducing intake of simple sugars, fructose, and alcohol.
What if? If a patient presents with extremely low cholesterol and triglyceride levels along with neurological symptoms (like ataxia) and signs of fat-soluble vitamin deficiency, a nurse should recognize these as potential signs of a malabsorption syndrome like Abetalipoproteinemia and ensure prompt physician evaluation.

How to Approach the Question

First, identify the keywords in the question: "Elevated serum triglyceride levels" and the crucial negative word "EXCEPT".
This means you are looking for the one condition out of the four options that does NOT cause high triglycerides.
Analyze each option's effect on lipid metabolism.
Recall or deduce that Type 2 DM, high sugar/fructose diets, and nephrotic syndrome are all well-known secondary causes of hypertriglyceridemia.
Consider Abetalipoproteinemia. The prefix 'a-' means 'without' or 'lack of'. 'Lipo' refers to fat/lipids and 'protein' to protein. The name itself suggests a problem with lipoproteins.
Conclude that a disorder preventing the formation of lipoproteins (which transport triglycerides) would lead to low, not high, levels of triglycerides in the blood. This makes it the correct exception.

Concept Tested & Keywords

Concept Tested: Pathophysiology of dyslipidemia and causes of abnormal serum triglyceride levels.
Stem keywords: elevated, serum triglyceride levels
Lead-in keywords: EXCEPT
Negative lead-in flag: Question asks for the exception.

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