A 50-year-old man is evaluated during a routine physical examination, He is asymptomatic, has no medical problems, and takes no medications. His father, uncle, and a brother had myocardial infarctions between the ages of 55 and 60 years. On examination, vital signs are normal. BMI is 28. On skin examination, he has soft, non-tender, yellow plaques measuring between 0.5 and 1 cm on his upper eyelids. The remainder of the physical examination results are normal. Which of the diagnostic studies should be done next?
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الإجابة: C. Serum lipids
Yellow plaques on the upper eyelids are xanthelasmas, a sign of a lipid disorder; with a strong family history of premature MI, familial hypercholesterolaemia is suspected. The next test is a (fasting) lipid profile.
- Glucose/HbA1c, LFTs and TSH are part of the wider work-up for secondary causes, but the lipid panel is the key first investigation.
ليش كل خيار صح أو غلط
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A
ليش غلط
Liver tests look for cholestatic liver disease, a secondary cause of high cholesterol that comes with jaundice, high ALP and bilirubin; his exam is otherwise normal, and eyelid plaques with a family history of early heart disease point to a lipid disorder.
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B
ليش غلط
Glucose/HbA1c looks for diabetes, a secondary cause of dyslipidemia (high TG, low HDL, obesity, acanthosis nigricans). It is a later work-up step, not the first test for xanthelasma.
✓ view-material.pdf · p. 22 -
C
ليش صح
Xanthelasma with a family history of early CAD suggests familial hypercholesterolemia, so the serum lipid profile is the next test.
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D
ليش غلط
TSH looks for hypothyroidism, which raises LDL and TG but comes with fatigue, cold intolerance and weight gain; this man is asymptomatic.
✓ view-material.pdf · p. 22
- المصدر
- Endocrine ✳️.pdf · p. 28
view-material.pdf · p. 22 - المحاضرة
- Obesity & Lipids · Endocrinology · Module B
- ظهر في
- Endo bank