In hyperlipoproteinemia, which plasma appearance is associated with high chylomicrons (CM)?

• A. Creamy layer on top
• B. Turbid plasma
• C. Clear plasma
• D. Hemolyzed plasma

Answer: (A)

Chylomicrons are the largest, least dense lipoproteins, so they rise to the surface of serum when it stands. In hyperlipoproteinemia with excess chylomicrons, this causes a distinct creamy layer to form on top of the sample. That creamy layer is the visual cue signaling high chylomicrons, as opposed to turbid plasma which points to elevated VLDL, clear plasma which indicates normal lipid levels, or a hemolyzed sample which is an artifact of handling. So the presence of a creamy layer on top reflects high chylomicrons.