This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Unknown
[{'content': 'A 37-yrs-old man in DKA has yellowish papules scattered over his trunk and extremities. A tube of plasma that is collected from the patient develops a turbid supernate. This is consistent with which type of hyperlipoproteinemia? \nSelect and explain. \nA. Type I, B. Type II, C. Type III, D. Type V', 'role': 'user'}, {'content': 'Answer: D \nExplanation: The patient most likely has a type V hyperlipopro\xadteinemia, which is associated with eruptive xanthomas secondary to increased triacylglycerol. Type V hyperli\xadpoproteinemia is a combination of type I, characterized by elevated chylomicrons, and type IV, characterized by increased very-low-density lipoproteins (VLDL). Diabetic ketoacidosis and alcoholism are two of the most common factors that promote type V hyperlipo\xadproteinemia. The absence of insulin characteristic of diabetic ketoacidosis decreases capillary lipoprotein li\xadpase activity, so neither chylomicrons nor VLDL are properly metabolized in the liver. The increased triac\xadylglycerol concentration that results from the accumu\xadlation of chylomicrons and VLDL in the blood pro\xadduces a turbid specimen. Because chylomicrons have the lowest density, they form a turbid supranate in plasma left at 4°C overnight. The density of VLDL is slightly higher than that of chylomicrons, so it forms a turbid infranate. Presence of a supranate and in\xadfranate, as in this case, indicates type V hyperlipopro\xadteinemia. A supranate without an infranate occurs in type I hyperlipoproteinemia, and an infranate without a supranate occurs in type IV hyperlipoproteinemia. Another feature of type V disease is hyperchylomicro\xadnemia. Clinical features include eruptive xanthomas caused by the deposition of triacylglycerol in the sub\xadcutaneous tissue. Once the triacylglycerol concentra\xadtion is reduced, the xanthomas disappear.', 'role': 'assistant'}]