12-27-2008, 08:13 PM
5. A 42-year-old man presents to clinic for routine
evaluation. His medical history is significant
only for gallstones. The patient denies
smoking and drinks alcohol occasionally. His
mother had a heart attack at the age of 63. His
vital signs are significant for a blood pressure
of 134/77 mm Hg and on physical examination,
he is overweight with well-healed laparoscopic
cholecystectomy scars. His fasting lipid
panel and other laboratory values are:
Aspartate aminotransferase 37 U/L
Alanine aminotransferase 28 U/L
Alkaline phosphatase 88 U/L
Total cholesterol 268 mg/dL
LDL cholesterol 183 mg/dL
HDL cholesterol 46 mg/dL
Triglycerides 166 mg/dL
What is the most appropriate next step in the
patient™s management?
(A) A trial of lifestyle modification alone (diet,
exercise, and weight loss)
(B) A trial of lifestyle modification combined
with statin and niacin therapy
© A trial of lifestyle modification combined
with statin therapy
(D) Niacin therapy
(E) Statin therapy
evaluation. His medical history is significant
only for gallstones. The patient denies
smoking and drinks alcohol occasionally. His
mother had a heart attack at the age of 63. His
vital signs are significant for a blood pressure
of 134/77 mm Hg and on physical examination,
he is overweight with well-healed laparoscopic
cholecystectomy scars. His fasting lipid
panel and other laboratory values are:
Aspartate aminotransferase 37 U/L
Alanine aminotransferase 28 U/L
Alkaline phosphatase 88 U/L
Total cholesterol 268 mg/dL
LDL cholesterol 183 mg/dL
HDL cholesterol 46 mg/dL
Triglycerides 166 mg/dL
What is the most appropriate next step in the
patient™s management?
(A) A trial of lifestyle modification alone (diet,
exercise, and weight loss)
(B) A trial of lifestyle modification combined
with statin and niacin therapy
© A trial of lifestyle modification combined
with statin therapy
(D) Niacin therapy
(E) Statin therapy