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{{WBRQuestion
{{WBRQuestion
|QuestionAuthor={{MM}}
|QuestionAuthor= {{MM}}
|ExamType=USMLE Step 3
|ExamType=USMLE Step 3
|MainCategory=Primary Care Office
|MainCategory=Primary Care Office
|SubCategory=Endocrine
|SubCategory=Endocrine, Endocrine
|MainCategory=Primary Care Office
|MainCategory=Primary Care Office
|SubCategory=Endocrine
|SubCategory=Endocrine, Endocrine
|MainCategory=Primary Care Office
|MainCategory=Primary Care Office
|SubCategory=Endocrine
|SubCategory=Endocrine, Endocrine
|MainCategory=Primary Care Office
|MainCategory=Primary Care Office
|MainCategory=Primary Care Office
|MainCategory=Primary Care Office
|SubCategory=Endocrine
|SubCategory=Endocrine, Endocrine
|MainCategory=Primary Care Office
|MainCategory=Primary Care Office
|SubCategory=Endocrine
|SubCategory=Endocrine, Endocrine
|MainCategory=Primary Care Office
|MainCategory=Primary Care Office
|SubCategory=Endocrine
|SubCategory=Endocrine, Endocrine
|MainCategory=Primary Care Office
|MainCategory=Primary Care Office
|SubCategory=Endocrine
|SubCategory=Endocrine, Endocrine
|MainCategory=Primary Care Office
|MainCategory=Primary Care Office
|MainCategory=Primary Care Office
|MainCategory=Primary Care Office
|SubCategory=Endocrine
|SubCategory=Endocrine, Endocrine
|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:
|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
* Total blood cholesterol of 270mg/dL
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In addition to diet, exercise, and smoking cessation, which of the following would have the greatest effect in reducing her cholesterol?
In addition to diet, exercise, and smoking cessation, which of the following would have the greatest effect in reducing her cholesterol?
|Explanation=[[Diabetes mellitus]] control would positively affect the lipid profile by lowering [[LDL]] and [[triglyceride]] levels and, therefore, decreasing [[total cholesterol]]
|Explanation=[[Diabetes mellitus]] control would positively affect the lipid profile by lowering [[LDL]] and [[triglyceride]] levels and, therefore, decreasing [[total cholesterol]]
|AnswerA=Controlling her blood pressure
|AnswerA=Controlling her blood pressure
|AnswerAExp=Incorrect
|AnswerAExp=Incorrect
Controlling blood pressure has no known direct effect on lipid profile
Controlling blood pressure has no known direct effect on lipid profile
|AnswerB=Controlling her diabetes mellitus
|AnswerB=Controlling her diabetes mellitus
|AnswerBExp=Correct
|AnswerBExp=Correct
By controlling her [[diabetes mellitus]], will lowering [[LDL]] and [[triglyceride]] levels and, therefore, decreasing [[total cholesterol]]
By controlling her [[diabetes mellitus]], will lowering [[LDL]] and [[triglyceride]] levels and, therefore, decreasing [[total cholesterol]]
|AnswerC=Adding alcoholic beverages twice per day
|AnswerC=Adding alcoholic beverages twice per day
|AnswerCExp=Incorrect  
|AnswerCExp=Incorrect  
Alcohol cannot be used as main line in the treatment of high lipid profile
Alcohol cannot be used as main line in the treatment of high lipid profile
|AnswerD=Improving her sleeping habits
|AnswerD=Improving her sleeping habits
|AnswerDExp=Incorrect
|AnswerDExp=Incorrect
Sleeping will not reduce her lipid profile.
Sleeping will not reduce her lipid profile.
|AnswerE=Adding thyroid hormone to her medications.
|AnswerE=Adding thyroid hormone to her medications.
|AnswerEExp=Incorrect
|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.
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.
|RightAnswer=B
|RightAnswer=B
|WBRKeyword=[[Diabetes mellitus]], [[Hypercholesterolemia]]
|Approved=No
|Approved=No
}}
}}

Latest revision as of 02:41, 28 October 2020

 
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::