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Old 03-05-2013
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Default Next best step in abnormal lipid profile

A 45 year old man presents to your office for follow up of his dyslipidemia that was diagnosed 6 month. His lipid panel at that time was consistent with high Total cholesterol , Low HDL and high triglyceride levels. He was instructed on dietary modification. He presents for a follow up visit today and reports that he had been strictly compliant with reduced fat diet. His social history is significant for smoking 1 pack per day for the past 25 years . He reports drinking about 1 pint vodka per day for past 10 years. He read on an online magazine that drinking alcohol would boost his “Good” cholesterol. At this time, a repeat fasting lipid profile reveals:

Total Cholesterol : 250mg%

HDL cholesterol : 35mg%

Triglycerides: 500mg%

The most important step at this time to address his lipid abnormalities:

A) Niacin

B) Gemfibrozil

C) Fenofibrate

D) Alcohol cessation

E) Smoking cessation
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  #2  
Old 03-06-2013
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Default D) Alcohol cessation

D) Alcohol cessation
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Old 03-06-2013
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Originally Posted by fadi551 View Post
D) Alcohol cessation
Absolutely correct...if he stops drinking and yet his lipid profile remains the same what would be the next step?
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Old 03-06-2013
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Originally Posted by stfidel View Post
Absolutely correct...if he stops drinking and yet his lipid profile remains the same what would be the next step?
For that we should know the LDL levels to decide between A & C
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Old 03-06-2013
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Default TG of 500mg/dl rate limiting

TG level greater than or equal to 500 is an indication to start Fibrate to prevent pancreatitis irrespective of LDL level...the fear of pancreatitis is the begining of wisdom
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Old 03-06-2013
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Originally Posted by stfidel View Post
TG level greater than or equal to 500 is an indication to start Fibrate to prevent pancreatitis irrespective of LDL level...the fear of pancreatitis is the begining of wisdom
Good point..........I forgot about that.
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