03-12-2008, 01:30 PM
A 58-year-old man presents for an initial physical examination and for review of laboratory results obtained at a local health fair. He denies any specific complaints today. His medical history is significant for diabetes, hypertension, hyperlipidemia, and fatty liver. He is not currently on any medications. He takes a multivitamin and baby aspirin daily. He denies chest pains, shortness of breath, gastrointestinal, or genitourinary complaints. He does not smoke. He is 70 inches tall, weighs 230 pounds (BMI 33). Blood pressure is 160/98 mm Hg and pulse is 68 beats per minute. He does not have any carotid bruits, thyroid examination is normal, and heart is regular without murmur. Lung examination is normal. He does not have any abdominal bruits. Liver is slightly tender. He has normal lower extremity pulses. Laboratory studies are significant for the results shown below. Considering this patient™s risk for atherosclerotic disease, what is correct?
Alanine aminotransferase (ALT) 70 U/L
Aspartate aminotransferase (AST) 48 U/L
Other liver tests are normal.
Glucose 140 mg/dL
Total cholesterol 250 mg/dL
High-density lipoprotein (HDL) 30 mg/dL
Triglycerides 250 mg/dL
Low density lipoprotein (LDL) 170 mg/dL
Blood urea nitrogen (BUN) 18 mg/dL
Serum creatinine 1.8 mg/dL
A. Angiotensin-converting enzyme (ACE) inhibitors should be avoided in this patient
B. Beta blockers are contraindicated in this patient
C. This patient™s glucose control is adequate
D. This patient™s target blood pressure is 140/90 mm Hg
E. Treatment for hyperlipidemia with statin drugs is appropriate in this patient
Alanine aminotransferase (ALT) 70 U/L
Aspartate aminotransferase (AST) 48 U/L
Other liver tests are normal.
Glucose 140 mg/dL
Total cholesterol 250 mg/dL
High-density lipoprotein (HDL) 30 mg/dL
Triglycerides 250 mg/dL
Low density lipoprotein (LDL) 170 mg/dL
Blood urea nitrogen (BUN) 18 mg/dL
Serum creatinine 1.8 mg/dL
A. Angiotensin-converting enzyme (ACE) inhibitors should be avoided in this patient
B. Beta blockers are contraindicated in this patient
C. This patient™s glucose control is adequate
D. This patient™s target blood pressure is 140/90 mm Hg
E. Treatment for hyperlipidemia with statin drugs is appropriate in this patient