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Chapter 12. Dyslipidemias

Student Questions

What is this patient's non-HDL cholesterol and LDL cholesterol?

A 54-year-old man presents to your clinic today for routine follow-up on his type 2 diabetes mellitus. His mother and father are both living and have no known heart disease. He tries to follow a low sugar and low sodium diet. The patient smokes ½ pack of cigarettes per day but is otherwise healthy. His lipid panel today is: total cholesterol 250 mg/dL (6.47 mmol/L), HDL cholesterol 44 mg/dL (1.14 mmol/L), and triglycerides 180 mg/dL (2.03 mmol/L).

A. 184 mg/dL (4.76 mmol/L) and 154 mg/dL (3.98 mmol/L)

B. 206 mg/dL (5.33 mmol/L) and 170 mg/dL (4.40 mmol/L)

C. 214 mg/dL (5.53 mmol/L) and 185 mg/dL (4.78 mmol/L)

D. 236 mg/dL (6.10 mmol/L) and 202 mg/dL (5.22 mmol/L)

Answer: B

Option A: Incorrect. The calculation for non-HDL cholesterol is total cholesterol – HDL cholesterol (250 – 44 = 206) or (6.47 – 1.14 = ~5.33). The calculation for LDL cholesterol is total cholesterol – (HDL cholesterol + triglycerides/5) (250 – [44 + 180/5] = 170) or total cholesterol – (HDL cholesterol + triglycerides/2.2) (6.47 – [1.14 + 2.03/2.2] = ~4.40).

Option B: Correct. The calculation for non-HDL cholesterol is total cholesterol – HDL cholesterol (250 – 44 = 206) or (6.47 – 1.14 = ~5.33). The calculation for LDL cholesterol is total cholesterol – (HDL cholesterol + triglycerides/5) (250 – [44 + 180/5] = 170) or total cholesterol – (HDL cholesterol + triglycerides/2.2) (6.47 – (1.14 + 2.03/2.2) = ~4.40).

Option C: Incorrect. The calculation for non-HDL cholesterol is total cholesterol – HDL cholesterol (250 – 44 = 206) or (6.47 – 1.14 = ~5.33). The calculation for LDL cholesterol is total cholesterol – (HDL cholesterol + triglycerides/5) (250 – [44 + 180/5] = 170) or total cholesterol – (HDL cholesterol + triglycerides/2.2) (6.47 – [1.14 + 2.03/2.2] = ~4.40).

Option D: Incorrect. The calculation for non-HDL cholesterol is total cholesterol – HDL cholesterol (250 – 44 = 206) or (6.47 – 1.14 = ~5.33). The calculation for LDL cholesterol is total cholesterol – (HDL cholesterol + triglycerides/5) (250 – [44 + 180/5] = 170) or total cholesterol – (HDL cholesterol + triglycerides/2.2) (6.47 – [1.14 + 2.03/2.2] = ~4.40).

What is this patient's primary target for intervention?

A 54-year-old man presents to your clinic today for routine follow-up on his type 2 diabetes mellitus. His mother and father are both living and have no known heart disease. He tries to follow a low sugar and low sodium diet. The patient ...

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