Guptashutosh
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19. A 43-year-old man comes to the physician for evaluation and management of cardiac risk factors 8 weeks after sustaining a myocardial infarction. He takes aspirin and metoprolol daily, and he does not smoke cigarettes. His father and brother both had myocardial infarctions before the age of 50 years; their serum cholesterol levels are unknown. There is no family history of diabetes mellitus. He weighs 86 kg (190 lb) and is 180 cm (71 in) tall. His blood pressure is 130/70 mm Hg, pulse is 68/min, and respirations are 14/min. Two years ago, his serum cholesterol level was 245 mg/dL. Fasting serum glucose level is 88 mg/dL. Which of the following is the most appropriate next step to evaluate his cardiac risk factors?
A ) Random measurements of serum cholesterol level
B ) Measurement of fasting serum cholesterol level only
C ) Fasting serum lipid studies only
D ) Oral glucose tolerance test and fasting serum lipid studies
E ) Oral glucose tolerance test and measurement of fasting serum cholesterol level
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| prathapdoctor
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random measurement of serum cholesterol level.
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| fox
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C
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| fox
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Doesnt lipid study involve cholesterol as well?
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| robin082006
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B
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| Guptashutosh
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wat is the need / benefit of fasting chol over random ?
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| sarika
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i think fasting gives u Ldl while random gives only hdl and total....we need fasting for the management of patient....random for screening
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| young_doc
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C. Fasting Lipids
We need to do "Total Cholesterol/HDL" to assess his Cardiac risk ratio, don't we?
Measuring Cholesterol alone doesn't really tell us much. The old school way was just to measure cholesterol, but nowadays it's actually the ratio of cholesterol to HDL that gives us the best indication of who's at risk for a cardiac event..
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| ndspider
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I agree with young_doc. It is C
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| r_albayunen
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C
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| Mahwish Mushtaq
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it's C
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| robin082006
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I checked it, answer is C
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| liwei
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He is fat, why not do the OGTT? I prefer E
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| young_doc
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Liwei, the way i see it, his last glucose check 2 years ago showed 88, and he has no family history of DM.
Unless you have reason to suggest he has DM, there is not need to put him through an OGTT. (being fat is not reason enough to suggest he could have DM)..
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