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

Appeared in: AIIMS Patna NO - 2020

Explanation

Abetalipoproteinemia is a rare autosomal recessive genetic disorder.
It is caused by mutations in the MTTP gene, which is crucial for assembling and secreting apolipoprotein B (ApoB)-containing lipoproteins.
Without functional ApoB, the body cannot form chylomicrons (to transport dietary fats) or very-low-density lipoproteins (VLDL) (to transport fats from the liver).
This failure of lipoprotein formation and transport results in a marked decrease, not an increase, in plasma triglyceride and cholesterol levels.

Option B: Type 2 diabetes mellitus is a common cause of secondary hypertriglyceridemia.
Option C: A diet high in fructose is a well-established dietary cause of elevated triglycerides.
Option D: Nephrotic syndrome is a classic cause of secondary mixed hyperlipidemia, including elevated triglycerides.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Causes of Dyslipidemia (Hypertriglyceridemia vs. Hypolipidemia) as background academic context rather than a clinical decision trigger.
Understanding the diverse causes of dyslipidemia is crucial for nurses in providing effective patient education on diet, lifestyle modifications, and medication adherence to manage cardiovascular risk.
Nurses should be aware that patients with abetalipoproteinemia present with severe fat malabsorption (steatorrhea), failure to thrive, and deficiencies in fat-soluble vitamins (A, D, E, K), requiring lifelong, specialized dietary management and supplementation.
What if? If a patient had Familial Chylomicronemia Syndrome (Type I Hyperlipidemia) due to LPL deficiency, they would present with the opposite finding: extremely high triglyceride levels (often greater than 1000 mg/dL), leading to a risk of acute pancreatitis.

How to Approach the Question

First, identify the keyword 'EXCEPT'. This signals that you are looking for the option that does not fit the condition described in the stem (elevated triglycerides).
Evaluate each option's effect on triglyceride metabolism.
Recall that Type 2 diabetes, high sugar/fructose diets, and nephrotic syndrome are all associated with metabolic disturbances that typically increase lipid levels.
Analyze the term 'Abetalipoproteinemia'. The prefix 'A-' means 'without' or 'lack of'. This suggests a deficiency of lipoproteins, which are necessary to carry triglycerides in the blood.
Conclude that a lack of lipoproteins would lead to low blood triglycerides, making it the correct exception.

Concept Tested & Keywords

Qt239hQglXS3PtTHCUK56F

E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 923-925

E6 Medicine Davidson Principles Practice 24e p. 393-395

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