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  #1  
Old 10-17-2011
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Default Endocrine

A 45-year-old man with a longstanding history of diabetes comes to the clinic with increasing claudication. He also has known peripheral vascular disease. He denies symptoms of chest pain or shortness of breath. He denies any other past medical history. He currently is receiving insulin. He has no known allergies. He has documented vascular disease with a documented ankle– the brachial index <0.90. As part of his evaluation, his lipid profile is obtained. Which of the following information also should be obtained?



A.

C-reactive peptide


B.

Exercise stress tests


C.

Fasting glucose level


D.

Hemoglobin A1C


E.

Lipoprotein (a)
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  #2  
Old 10-18-2011
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i go wid ans B. exercise stress test . to r/o aterosclerosis. im nt sure.
hey wat s d source f ur qstns. thanks for postin those..
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Old 10-18-2011
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D. Hemoglobin A1C
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  #4  
Old 10-18-2011
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D.

Hemoglobin A1C
__________________
I'm Predictable In The Unpredictable Future !
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  #5  
Old 10-18-2011
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i will go for Hb A1c
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  #6  
Old 10-18-2011
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Default We are the best of the best

B exercise stress test
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  #7  
Old 10-18-2011
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B exercise stress test.
We should focuse on current problem which was not(D.M controlled or not)
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  #8  
Old 10-18-2011
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Will go with Exercise stress test. But not 100% sure.
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Old 10-18-2011
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Correct Answer Answer

The correct answer is D. Given this patient’s known history of peripheral vascular disease and diabetes, he needs intensive risk reduction. This involves optimizing his lipid panel and hemoglobin A1C, which is an indication of his diabetic control. Additionally, his blood pressure needs to be controlled.
C-reactive peptide (choice A) is gaining increasing recognition for its association with inflammation and cardiovascular disease. It is, however, a marker for disease. Elevated levels do not guide management.
Because this patient is not presenting with obvious signs of cardiac distress or chest pain, an exercise stress test for risk stratification purposes is not required (choice B).
This patient has known diabetes. Measurement of his fasting glucose level thus is not needed because the diagnosis is known already (choice C).
Lipoprotein (a) (choice E) also is gaining increasing recognition for its association with inflammation and cardiovascular disease. It is, however, a marker for disease. Elevated levels do not guide management.
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Old 10-18-2011
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Hemoglobin A1C
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