1. LIPID PROFILE For optimal results, the patient should be on a stable diet for 2-3 weeks prior to testing.

Patient should fast for 12 to 14 hours before blood collection. Fasting should be no food or drink except for water. For the most accurate results, wait at least two months after a heart attack, surgery, infection, injury or pregnancy to check cholesterol levels. Cleveland Clinic. (n.d.). Cleveland Clinic. Retrieved September 25, 2013, from http://my.clevelandclinic.org/heart/diagnostics-testing/laboratory-tests/lipid-blood-tests.aspx 2. Posture- variations are to be expected in the conc. Of lipid constituents w/c are protein bound and hence are not filterable when going from supine to erect position. Prolonged standing over 30mins can cause a 10-15% increase in the conc.of protein. A change from an upright to supine position, due to dilutional effect can reduce after 5mins in supine position the chol level by 10% and tag level by 12% because of plasma increased w/in 15mins of a change from supine to sitting position. Leaving the tourniquet on during blood collection for more than 1min thru hemoconcentration increase the tchol conc. From 5%-2min, 10-15%- 5mins Fasting- fatty meal increase serum tag conc up to 9hrs. Anticoagulant- EDTA: prevents oxidation of lipids, and minimize hydrolysis of tag Narayanan, S. (1996, January 1). Pre and post analytical errors in lipid determination Springer. Home - Springer. Retrieved September 25, 2013, from http://link.springer.com/article/10.1007%2FBF02868405#page-1

3. This calculation is not valid when the triglyceride is greater than 400 mg/dL. Increased levels of VLDL-cholesterol have been found to be associated with increased risk of heart disease and stroke. Triglyceride levels ranging from 400-1000 mg/dL are considered high and levels greater than 1000 mg/ dL are considered very high. High levels of triglycerides may indicate liver disease (cirrhosis), an underactive thyroid problem, uncontrolled diabetes, an infection of the pancreas (pancreatitis), kidney disease, or a diet too low in protein and too high in carbohydrates. Estimating VLDL concentration from triglycerides is not valid when the triglycerides exceed 400 mg/dL (4.5 mmol/L). The Friedewald equation, LDL-C = TC HDL-C triglycerides/5, is used to estimate LDL cholesterol. The term triglycerides/5 is used to estimate the VLDL-cholesterol concentration. In estimating VLDL from triglycerides, one assumes there are no chylomicrons in the sample and that there are no unusual lipoproteins in the sample that would alter the typical ratio of triglycerides to VLDL particles. It is well documented in the literature that the Friedewald equation begins to give less reliable results when the triglycerides exceed 200 300 mg/dL (2.33.4 mmol/L), and it is not recommended when the triglycerides are greater than 400 mg/dL (4.5 mmol/L) because the term triglycerides/5 no longer provides a reliable estimate of the VLDL-C. College of American Pathologists - Q and A . (2008, July 1). College of American Pathologists CAP Home . Retrieved September 25, 2013, from http://www.cap.org/apps/cap.portal?_nfpb=true&cntvwrPtlt_actionOverride=%