NBME f1-3 - jn1

[ArchivalUser]

42-y man for routine exam. No FH of CAD, no smoke, his weight is appropriate for his height. Bp 120/80, total cholesterol 190, HDL 40, triglyceride 150. Which of the following is the most appropriate next step in management?

A Recommand the step 2 National Cholesterol Education Program diet
B Measure serum LDL-cholesterol now
C Measure total cholesterol in 5 years
D Aspirin
E Lovastatin

[ArchivalUser]

B. cause further measures depend on value of LDL.

[ArchivalUser]

This q is repeated. Today.

[ArchivalUser]

we can figure it out by :
LDL=total-HDL-tg/5
B is not the answer

[ArchivalUser]

so this pt has

190-40-150/5=190-40-30=190-70=120 LDL

so ldl 120 without risk factor we do not have to do anything now /so follow up after 5 yrs is the answer/but in real life case we will advice him to exercise because his hdl is at the lower limit

c is the ans.

[ArchivalUser]

no then answer will be A as our aim to keep LDL below 100 so this pt should follow the diet plan

[ArchivalUser]

ther is no fx and there are no other risk factor/ please understand this chapter.

you do not want to be a strict doctor that you advice dietary restriction so soon ,

thanks

[ArchivalUser]

you are right djyoti .......thank you so much.

[ArchivalUser]

djyoti , please can you repeat tom e how did you calculated the LDL?

[ArchivalUser]

total cholesterol==190

hdl =40

triglyceride=150


LDL=total cholestrol - hdl - triglyceride/5

therfore

ourLDL = 190 - 40 - 170/5 NOW 150 DIVIDED BY 5 IS EQUAL TO 30


SO LDL = 190 -40 -30
=190-70
=120