40-year-old patient came for a regular checkup. He has no significant medical problems except hypercholesterolemia. He is on statin (atorvastatin 40 mg daily), and lifestyle diet control and exercise. lipid profile revealed total cholesterol 220 mg/di, low density lipoprotein (LDL) 115 mg/dl, high density lipoprotein (HDL) 35 mg/dl, and triglycerides 550 mg/dI What is your advice for the patient as regard lipid profile?
سؤال مجاني 10 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
المصادر مختلفة. ملفات الدفعة فيها إجابتين، وما نرجّح وحدة على الثانية. سبب كل وحدة في الشرح تحت:
- إجابة: C. Continue the statin same dose and add fibrate therapy.
- إجابة ثانية: D. Discontinue statin therapy and prescribe fibrate therapy.
TG 550 mg/dL is severe hypertriglyceridaemia (pancreatitis risk) and needs a fibrate. Step Up says patients are usually kept on their LDL-lowering statin and other drugs are added if TG stays high, which supports continuing the statin and adding a fibrate (C).
- The old key (D: stop statin, switch to fibrate) leans on the CV-risk lecture's note that primary-prevention statin guidance does not apply when TG > 400 mg/dL. Sources don't settle it, so check with your lecturer.
ليش كل خيار صح أو غلط
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A
ليش غلط
TG 550 is in the severe range (>500 mg/dL), where the table adds a fibrate to prevent pancreatitis, so keeping the same regimen and only reinforcing lifestyle is not enough.
✓ view-material.pdf · p. 24 -
B
ليش غلط
Atorvastatin 40 mg is already a high-intensity LDL-lowering dose (LDL here is 115); the problem is TG 550, which the table treats with a fibrate.
✓ view-material.pdf · p. 24 -
C
ليش صح
Disputed. Supported by Step Up: patients usually stay on their LDL-lowering statin, and if TG stays high, additional drugs (fibrates among them) can be considered.
✓ Step Up To Medicine 6th Edition 2024(HEDACHE).pdf · p. 1 -
D
ليش صح
Disputed. Supported by the CV-risk lecture: its primary-prevention statin recommendations do not apply when TG is above 400 mg/dL, which is the basis offered for stopping the statin.
✓ CV Risk factor 4th year 2023 copy.pdf · p. 22
- المصدر
- Step Up To Medicine 6th Edition 2024(HEDACHE).pdf · p. 1
view-material.pdf · p. 24
CV Risk factor 4th year 2023 copy.pdf · p. 22 - المحاضرة
- Obesity & Lipids · Endocrinology · Module B
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