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Author15 Posts
nadiabarati

03/24/07 - 03:07 AM       #1

A 42-year-old man comes for a routine health maintenance examination. There is no family history of coronary artery disease, and he does not smoke. His weight is appropriate for his height. His blood pressure is 120/80 mm Hg. Serum lipid studies show a total cholesterol level of 190 mg/dL, HDL-cholesterol level of 40 mg/dL, and triglyceride level of 150 mg/dL. Which of the following is the most appropriate next step in management? A
) Recommend the Step 2 National Cholesterol Education Program diet B
) Measure serum LDL-cholesterol level now C
) Measure total serum cholesterol level in 5 years D
) Prescribe prophylactic aspirin E
) Begin treatment with lovastatin



yasmeen
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03/24/07 - 04:55 AM       #2

C?

vanshita
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03/24/07 - 06:42 AM       #3

can you please tell me what is answer
i think mesure serunm cholesterol level now

robin082006
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03/24/07 - 08:40 AM       #4

Measure total serum cholesterol level in 5 years

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92306
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03/24/07 - 08:49 AM       #5

C) Measure total serum cholesterol level in 5 years


damngood
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03/25/07 - 08:50 PM       #6

B should be the answer
for screening purposes the recommended protocol is to use
1. total cholesterol
2.hdl cholesterol
screen all men above 35 and all women above 45
after that
the management protocol depends on the ldl levels soo we first need to measure that before we proceed to intervention



correct me if i am wrong

Aashi
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03/26/07 - 04:34 AM       #7

Damn good, U r rt abt the screening protocol and LDL is not a part of the protocol, only when Total cholestrol is >200 ---->u go for fasting LDL levels to decide on t/t,wether diet or med..all the levels are normal in this pt, and he just requires rescreeening in the next 5 yrs..

GLwink

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monterusca2004
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03/26/07 - 02:16 PM       #8

I got the point

damngood
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03/27/07 - 08:54 PM       #9

yea aashi u r right didnt notice that
thanks for correctin me

docnikki
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03/28/07 - 06:01 AM       #10

I agree.Its C smiling face

docnikki
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03/28/07 - 06:03 AM       #11

this is given in UW preventive medicine.
Screening is reasonalble every 5 years.
we screen men over 35 and women over 45
but we can start at 20 years for both IF they are high risk..like if they
-have diabetes
-have fam h/o familial lipid disorders
-have a male relative over 50yrs or female relative over 60years with CVD
-presence of multiple risk factors for CAD for screening--> total cholesterol and HDL-cholesterol is recommended.
this can be done by both fasting and non fasting methods..ok. if total cholesterol is over 240 then we go for measuring LDL cholesterol which MUST be done only by fasting method.( coz if pt has had a meal then there will be false elevation of LDL)
we dont screen routinely with LDL levels coz its costly, also requires fasting.
based on this LDL we will make the interventions


nadiabarati

03/28/07 - 06:56 AM       #12

Nikki, there is a Q in pediatrics UW that explains a father who brings his obese 10 years-old son because the father has high cholesterol and CAD, so he's worried for his son.

the best thing for son is screen for total cholesterol, So I think in the case of risk factors in family, we don't need to wait till 20 years of age! What do you think?


docnikki
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03/29/07 - 11:52 PM       #13

oh yes ndaia I remember the quest, I think you are right..we will not wait till 20 years.

AAAAA
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03/30/07 - 03:35 AM       #14

nadiabarati wrote:
A 42-year-old man comes for a routine health maintenance examination. There is no family history of coronary artery disease, and he does not smoke. His weight is appropriate for his height. His blood pressure is 120/80 mm Hg. Serum lipid studies show a total cholesterol level of 190 mg/dL, HDL-cholesterol level of 40 mg/dL, and triglyceride level of 150 mg/dL. Which of the following is the most appropriate next step in management?

A) Recommend the Step 2 National Cholesterol Education Program diet

B) Measure serum LDL-cholesterol level now

C) Measure total serum cholesterol level in 5 years

D) Prescribe prophylactic aspirin

E) Begin treatment with lovastatin





The answer is A



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AAAAA
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03/30/07 - 03:36 AM       #15

AAAAA wrote:




The answer is C Sorry




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