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  #1  
Old 11-02-2011
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Question Recommended screening Fasting /Non fasting?

A 41-year-old man presents to his physician for a routine physical examination. He is a new to this office and brings his previous medical record with him. He has no significant past medical history but he does have a strong family history of cancer and heart disease. His father and his brother both had myocardial infarctions before age of 55, and his sister, mother, and aunt had breast cancer. He exercises regularly and eats well, with most of his diet being low in saturated fat and cholesterol. He smokes one pack of cigarettes per week. His review of systems is unremarkable. He is very anxious and would like only minimal interventions done because of his good health. Which of the following is an age-appropriate screening test in this patient?

A. Fasting lipid profile
B. Non-fasting total cholesterol level
C. Oral glucose tolerance test
D. Prostate examination
E. Sigmoidoscopy

friends what is the answer..and justify ..thanx
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  #2  
Old 11-02-2011
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B. Non-fasting total cholesterol level



MI before age 55 ...hence we need to r/o type 2a hyperlipidemia...so as minimal tests need to be done i go with B
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Old 11-02-2011
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A fasting lipid profile
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Old 11-02-2011
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B - non fasting total cholesterol.
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Old 11-02-2011
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wats the answer?
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Old 11-02-2011
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Premature family history of CAD so the choice should be > A. Fasting lipid profile
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Old 11-03-2011
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Default need further clearification!!

Ok friends..actually i had doubt and i havent checked the current guideline AHA ...but the answer according to the qbank(which is quite old i think though few question are like of kaplan) is following..i am not sure ..so shared it u guys to confirm..

The correct answer is
B. The current recommendations for routine, age-appropriate screening are based, in some measure, on data from clinical trials. Depending on the source of the recommendations, there is considerable variability in these recommendations. One of the more agreed on recommendations is that, at least every 5 years, a random cholesterol level should be checked.

A fasting lipid profile (choice A) is usually obtained only after a screening cholesterol is shown to be greater than 240 mg/d
L
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Old 11-03-2011
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not agree with answer...have to recheck latest recommendations
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Old 11-03-2011
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b is reasonable. For the pt needed the minimal interventions.He could draw blood for Non-fasting total cholesterol level on the day he saw the doctor, and did not need to go the hospital again. If the non-fasting cholesterol is high enough, you have the reason let him for the non-fasting test.
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