01-13-2009, 04:29 AM
A 52-year-old woman with alcoholism comes to the physician after a serum cholesterol level of 290 mg/dL was found on a routine screening. She drinks a pint of vodka daily. She takes captopril for hypertension and glyburide for type 2 diabetes mellitus. She also has intermittent episodes of gout.
Fasting serum studies show:
Total cholesterol 252 mg/dL
HDL-cholesterol 80 mg/dL
Triglycerides 300 mg/dL
Glucose 118 mg/dL
Thyroid-stimulating hormone 4.5 μU/mL
Which of the following is the most appropriate next step in management?
A) Alcohol cessation
B) Better control of diabetes
C) Switch from captopril to calcium-channel blocking agent therapy
D) Gemfibrozil therapy
E) Thyroid replacement therapy
