Question of the Week# 483

A 50-year-old previously healthy man comes to his physician for a scheduled follow-up examination. He works as an electrician, which involves a significant amount of physical activity when working. He says he also runs 5 miles twice a week and is on a low-fat, low-cholesterol diet. His father died of a ‘heart attack’ at the age of 54, and he has smoked one pack of cigarettes daily for the past 25 years. He denies alcohol or illicit drug use. He says he leads a low-stress lifestyle and has no complaints. His current medication include lisinopril. On presentation, his blood pressure is 135/85 mm Hg. Laboratory studies from a week ago show:

Total cholesterol     287 mg/dL

HDL                        65 mg/dL

LDL                        180 mg/dL

Which of the following is the best next step in patient care?

A Initiate drug therapy for control of his hyperlipidemia
B Educate the patient about diet and exercise and repeat the tests within 4 weeks
C Educate the patient about diet and exercise and repeat the tests within a year
D Initiate a mandatory low-fat diet for the patient
E No intervention is indicated

 

4 Responses

  1. C

  2. A
    Because his 10 year risk of CVD is 12.2%

  3. a

  4. smoker , Fx of MI, high lipids i will go with A

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