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Dyslipidemia Cases Fall 2012 (1)

Deceased at age 53 from mi she does not smoke or

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deceased at age 53 from MI .  She does not smoke or drink  EtOH.   Her FLP 4 months ago was: TC = 245 mg/dL TG = 190 mg/dL HDL = 38 mg/dL LDL = 169 mg/dL
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What is the patient’s Framingham risk score? 5% 8% 20% 25% 0% 0% 0% 0% 1. 5% 2. 8% 3. 20% 4. 25%
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Patient Case #1 Age: 8 points TC: 5 points Non-smoker: 0 pts HDL: 2 points SBP: 4 points Total Points:  19 pts FRS: 8%
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Patient Case #1 Summary Risk factors: 4 Framingham risk score: 8% Risk category: moderate
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Patient Case #1 LDL goal: < 130 mg/dL Non-HDL goal: < 160 mg/dL HDL goal: > 50 mg/dL
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Patient Case #2 A 60 yo AA male presents to clinic for a new patient visit.   His PMH is significant for diabetes, HTN, and dyslipidemia.   His medications include insulin (for diabetes), lisinopril 40mg  PO daily (for hypertension), and pravastatin 40mg PO QHS  (for cholesterol).  He smokes  ½  ppd and drinks 2-3 beers  per week. Vitals: BP 128/74 mmHg; HR 68 bpm; Wt 220 lbs; Ht 5’11” His fasting labs today are: FPG: 140 mg/dL TC = 180 mg/dL TG = 240 mg/dL HDL = 26 mg/dL
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How many CVD risk factors does the patient have? 1 2 3 4 5 0% 0% 0% 0% 0% 1. 1 2. 2 3. 3 4. 4 5. 5
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Patient Case #2 60 yo AA male  presents to clinic for a new patient visit.   His PMH is significant for diabetes,  HTN , and dyslipidemia.   His medications include insulin (for diabetes),  lisinopril 40mg  PO daily (for hypertension),  and pravastatin 40mg PO QHS  (for cholesterol).  He  smokes  ½  ppd  and drinks 2-3 beers  per week. Vitals: BP 128/74 mmHg; HR 68 bpm; Wt 220 lbs; Ht 5’11” His fasting labs today are: FPG: 140 mg/dL TC = 180 mg/dL TG = 240 mg/dL HDL = 26 mg/dL
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Do you need to calculate a Framingham risk score? Yes No 0% 0% 1. Yes 2. No
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Patient Case #2 Summary Risk factors: 4 CHD risk equivalent (diabetes)  do NOT need to calculate a Framingham  risk score Risk category: high
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Patient Case #2 Calculate the patient’s LDL 180 – 26 – (240/5) = 106 mg/dL LDL goal:  < 100 mg/dL Non-HDL goal: < 130 mg/dL HDL goal: > 40 mg/dL
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Which of the following criteria for metabolic syndrome does the patient have?
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