Question of the Week # 382

382)  A 36  year old Caucasian man presents for a pre-employment health physical. He denies any health problems in the past. He does not smoke or drink alcohol. He denies drug abuse.  He enjoys good health and has no significant medical issues. He has no family history of Hypertension, Dyslipidemia, Diabetes or coronary artery disease.  On examination, his blood pressure is 118/74. Body Mass Index is 24kg/m2. Cardiac examination shows regular heart sound with no S3 gallop or S4. There are no audible murmurs. Abdominal examination is benign and there are no audible bruits. A complete blood count, comprehensive metabolic panel, urinalysis and urine drug screen are unremarkable. Which of the following is indicated at this time?

A) No additional Tests

B) Serum Total Cholesterol and HDL – cholesterol

C) Hemoglobin A1C

D) Fasting Plasma Glucose

E) Prostate Specific Antigen

8 Responses

  1. C) Hemoglobin A1C

  2. B) Serum total cholestrol and HDL cholesterol

    cholestrol screening should do at age 35 in men and 45 in women even patient doesn’t have risk factors.

    diabetes screening should be considered when the patient has risk factors such as obesity, impaired fasting glucose, positive family history, etc.

    • Agreed routine diabetic screening is not recommended when there’s no risk factor I was thinking he might be having IDDM 😛

      Lipid profile should be done in all men 35/> in women 45/> with risk factors for coronary artery disease.

  3. D

  4. A

  5. LIPID profile screening……35 (M), 45 (F)……otherwise 20 yr for both if they have { risk factors (2 or more) for CAD OR +ve family Hx of dyslipidimia or premature CAD OR DM OR any CAD equivalents OR evidence of hyperlipidemia on examination} then repeat in 5 years…

    HbA1C ……should be screened in any HYPERTENSION pt. >135/80 OR any HYPERLIPIDEMIA pt.

  6. A.

  7. b

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