Dyslipidemias Quiz: Ace Your Exams

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A 30-year-old man comes to the emergency department because of abdominal pain that started two hours ago. He reports that the pain radiates to the back and is 8 out of 10 in severity. The patient eats a well-balanced diet, consumes 1-2 beers per week, and denies recent abdominal trauma. Family history is notable for hypertension in his father. Physical examination shows pain on light palpation of the epigastric region. Hepatosplenomegaly is noted. Multiple small red-yellow papules are present on the patient’s buttocks and shoulders. Laboratory testing reveals the following results:  
 
Laboratory value Result 
Sodium  139 mEq/L 
 Potassium  4.2 mEq/L 
 Calcium  7.9 mg/dL 
 Triglyceride  860 mg/dL 
 Serum Cholesterol (Total)  190 mg/dL 
 Lipase  310 U/L 

A deficiency in which of the following proteins is most likely responsible for this patient’s presentation?  

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