Total Cholesterol



Test Description


Cholesterol is synthesized in the liver from dietary fats. Its functions include being
used in the production of bile salts and several of the steroid hormones, and as a
part of cell membranes. Cholesterol is transported in the blood by the low density
lipoproteins (LDLs, or “bad” cholesterol) and high density lipoproteins (HDLs, or
“good” cholesterol). A great deal of research has focused on the role of cholesterol
in heart disease. High levels of cholesterol in the blood (hypercholesterolemia),
especially in combination with low levels of HDL, have been found to increase the
person’s risk of atherosclerosis and heart disease. This test allows evaluation of this
risk potential, assists in determining treatment options, and is used to monitor
effectiveness of treatment.

• In all adults aged 20 years or older, a fasting lipoprotein profile (total cholesterol, LDL cholesterol,
HDL cholesterol, and triglycerides) should be obtained once every 5 years. If the
testing opportunity is nonfasting, only the values for total cholesterol and HDL cholesterol
will be usable. In such a case, if total cholesterol is ≥200 mg/dL or HDL is <40 mg/dL, a
follow-up lipoprotein profile is needed for appropriate management based on LDL.
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Normal Values  : Desirable <200 mg/dL (<5.18 mmol/L SI units)

Abnormal Values
                         Borderline High: 200–239 mg/dL (5.18–6.19 mmol/L SI units)
                         High: >239 mg/dL (>6.20 mmol/L SI units)


Possible Meanings of Abnormal Values
Increased                                                               Decreased

Atherosclerosis                                                     AIDS
Biliary cirrhosis                                                    Chronic anemia
Cardiovascular disease                                         Hemolytic anemia
Hypercholesterolemia                                           Hyperthyroidism
Hyperlipidemia                                                     Hypolipoproteinemia
Hypertriglyceridemia                                            Liver disease
Hypothyroidism                                                    Malabsorption
Liver disease/biliary obstruction                           Malnutrition
Nephrotic syndrome                                              Pernicious anemia
Obesity                                                                   Sepsis
Pancreatic dysfunction                                           Severe infections
Preeclampsia                                                          Stress
Pregnancy
Uncontrolled diabetes mellitus
Xanthomatosis

Contributing Factors to Abnormal Values

• Drugs which may increase cholesterol levels: atypical antipsychotics, beta-blockers,
corticosteroids, disulfiram, lansoprazole, levodopa, lithium, oral contraceptives,
pergolide, phenobarbital, phenytoin, sulfonamides, testosterone, thiazide diuretics,
ticlopidine, venlafaxine.
• Drugs which may decrease cholesterol levels: ACE-inhibitors, allopurinol, androgens,
cholesterol lowering agents, erythromycin, estrogens, filgrastim, levothyroxine,
metformin, phenytoin, prazosin, tamoxifen, terazosin.
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Interventions/Implications

Pretest
• Explain to the patient the purpose of the test and the need for a blood sample to be
  drawn.
• Fasting for 12 hours is required prior to the test. Water is permitted.
• No alcohol is allowed for 24 hours prior to the test.

Procedure

• A 7-mL blood sample is drawn in a red-top collection tube.
• Gloves are worn throughout the procedure.

Posttest

• Apply pressure at venipuncture site. Apply dressing, periodically assessing for continued
bleeding.
• Label the specimen and transport it to the laboratory.
• Report abnormal findings to the primary care provider.
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Clinical Alerts           

• If the test result is >200 mg/dL, patient education is needed regarding:
               • reduced intake of saturated fat and cholesterol
               • increased physical activity
               • weight control
• Depending on levels of other lipoproteins and the degree of hypercholesterolemia
present, cholesterol-lowering medication may be initiated, along with lifestyle
modifications.
Cholinesterase.

تعليقات

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