WBR1123

Author	[[PageAuthor::Mohamed Moubarak, M.D. [1]]]
Exam Type	ExamType::USMLE Step 3
Main Category	MainCategory::Primary Care Office
Sub Category	SubCategory::Endocrine, SubCategory::Endocrine
Prompt	[[Prompt::A 35 year-old female comes to your office for follow up after being diagnosed with type 2 diabetes mellitus 1 month ago. She has been following a diet and exercise beside her metformin as an oral hypoglycemic therapy. The patient is hypertensive with blood pressure 160/90 mmHg on beta blockers, and smokes ½ pack per day for 10 years. Her labs have been sent to your office and shows: Total blood cholesterol of 270mg/dL LDL of 190mg/dL HDL of 28 mg/dL HgbA1C 9.8% ALT 15 IU/L AST 10 IU/L In addition to diet, exercise, and smoking cessation, which of the following would have the greatest effect in reducing her cholesterol?]]
Answer A	AnswerA::Controlling her blood pressure
Answer A Explanation	[[AnswerAExp::Incorrect Controlling blood pressure has no known direct effect on lipid profile]]
Answer B	AnswerB::Controlling her diabetes mellitus
Answer B Explanation	[[AnswerBExp::Correct By controlling her diabetes mellitus, will lowering LDL and triglyceride levels and, therefore, decreasing total cholesterol]]
Answer C	AnswerC::Adding alcoholic beverages twice per day
Answer C Explanation	[[AnswerCExp::Incorrect Alcohol cannot be used as main line in the treatment of high lipid profile]]
Answer D	AnswerD::Improving her sleeping habits
Answer D Explanation	[[AnswerDExp::Incorrect Sleeping will not reduce her lipid profile.]]
Answer E	AnswerE::Adding thyroid hormone to her medications.
Answer E Explanation	[[AnswerEExp::Incorrect The patient has no symptoms of hypothyroidism, and although thyroid hormone helps reducing the lipid level, it shouldn’t be used unless there are symptoms.]]
Right Answer	RightAnswer::B
Explanation	[[Explanation::Diabetes mellitus control would positively affect the lipid profile by lowering LDL and triglyceride levels and, therefore, decreasing total cholesterol Educational Objective: References: ]]
Approved	Approved::No
Keyword	[[WBRKeyword::Diabetes mellitus]], [[WBRKeyword::Hypercholesterolemia]]
Linked Question	Linked::
Order in Linked Questions	LinkedOrder::