nbme Q ck pls answer it - farista000125

[ArchivalUser]

42. A 42-year-old man comes for a routine health maintenance examination. There is no family history of coronary artery disease, and he does not smoke. His weight is appropriate for his height. His blood pressure is 120/80 mm Hg. Serum lipid studies show a total cholesterol level of 190 mg/dL, HDL-cholesterol level of 40 mg/dL, and triglyceride level of 150 mg/dL. Which of the following is the most appropriate next step in management?

A
) Recommend the Step 2 National Cholesterol Education Program diet

B
) Measure serum LDL-cholesterol level now

C
) Measure total serum cholesterol level in 5 years

D
) Prescribe prophylactic aspirin

E
) Begin treatment with lovastatin


anyone knows the answer???????????????/

[ArchivalUser]

C. check him in 5 years.

the patient appears to be the perfect picture of health. his calculated LDL is 180 ( LDL= TC-HDL + TG/5 ). no need to treat. ASA wouldn't hurt him.

[ArchivalUser]

Correct me if I'm wrong but the equation is TC=HDL+VLDV (which is equal to TG/5) + LDL
Which when rearranged is LDL= TC-HDL- TG/5 thus though the answer "C" is correct the patient has an LDL of 120 not 180 If the calculated LDL was 180 then I would be inclined to choose B as the answer. Any thoughts?

[ArchivalUser]

The answer is b guys since ldl level is ost imp for starting the statins in these people

thanks

[ArchivalUser]

U have to know the LDL value before taking a decision to choose C...C iS FOR SURE THE NEXT STEP......But I am not sure if we can measure LDL in LAB...Because b is saying meaure not calculate while LDL iS CALCULATE FROM THE FORMULA ABOVE....
In anyway, I will go for B than C..