190) A 45 year old man presents to your office for follow up of his dyslipidemia that was diagnosed 6 month. His lipid panel at that time was consistent with high Total cholesterol , Low HDL and high triglyceride levels. He was instructed on dietary modification. He presents for a follow up visit today and reports that he had been strictly compliant with reduced fat diet. His social history is significant for smoking 1 pack per day for the past 25 years . He reports drinking about 1 pint vodka per day for past 10 years. He read on an online magazine that drinking alcohol would boost his “Good” cholesterol. At this time, a repeat fasting lipid profile reveals:
Total Cholesterol : 250mg%
HDL cholesterol : 35mg%
Triglycerides: 500mg%
The most important step at this time to address his lipid abnormalities:
A) Niacin
B) Gemfibrozil
C) Fenofibrate
D) Alcohol cessation
E) Smoking cessation
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B
D
Total cholesterol is increased.
HDL decrease.
TG increase.
calculated LDL= Total cholesterol – HDL – Triglyceride/5 = 115
Therefore, answer is c) fenofibrate
because HDL is low and Triglyceride is very high.