Dyslipidemia CASE 5A

Aling D., 62 years old female who came in for a General Check-up General Data

Pertinent Information Aling D., 62/F, came in for general check-up Smoker (20-pack years) Frequently eats fatty food Sedentary lifestyle Father had history of ischemic cerebrovascular disease and MI at 38 y/o Urinalysis, CBG, EKG returned normal CXR: Atherosclerotic aorta PE: essentially unremarkable

Laboratory Results ParameterNormal ResultInterpretation Total Cholesterol <200 mg/dL; >/=240 mg/dL considered high 280 mg/dLHigh LDL <100 mg/dL optimal >/=190 mg/dL very high 190 mg/dLHigh HDL40-60 mg/dL50 mg/dLNormal Triglycerides<180 mg/dL145 mg/dLNormal

Step 1 Diagnosis and Risk Assessment

LOW RISK: < 3 of the following*  Hypertension  Familial hypercholesterolemia  LVH  Smoking  Family history of CAD  Male sex  Age > 55 years old  Proteinuria  Albuminuria  BMI ≥ 25 * CPG on Management of Dyslipidemia in the Philippines

Diagnosis and Risk Assessment LOW RISK: < 3 of the following*  Hypertension  Familial hypercholesterolemia  LVH  Smoking  Family history of CAD  Male sex  Age > 55 years old  Proteinuria  Albuminuria  BMI ≥ 25

Framingham Cardiac Risk Score

Primary Working Impression Dyslipidemia t/c metabolic syndrome Atherosclerosis High CV Risk

Step 2 Therapeutic Objectives

1. Lower cholesterol to normal levels pharmacologically 2. Reduce overall risk factors a. Smoking cessation b. Manage diet and promote active lifestyle c. Weight control (depends on his BMI and WHR) 3. Educate patient about medications (dosing, indications, adverse effects, etc.)