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Monty is a 52-year-old male following up on his labs that were drawn last week. He smokes 1 pack per day. He is currently on Lisinopril 20 mg po daily. He is allergic to penicillin. Fasting lipid profile shows:

- Total cholesterol: 266 mg/dL
- LDL cholesterol: 180 mg/dL
- HDL cholesterol: 40 mg/dL
- Triglycerides: 185 mg/dL

1. What treatment plan would you implement for Monty's lipid profile?
2. What are the goal Total Cholesterol (TC), HDL-C, and LDL-C levels for Monty?
3. How would you monitor the effectiveness of your treatment plan?
4. How many risk factors for coronary artery disease does this patient have? Identify them specifically.

Options:

A) Prescribe statin therapy; TC < 200 mg/dL, HDL-C > 40 mg/dL, LDL-C < 100 mg/dL; Monitor lipid profile every 3 months; Two risk factors: smoking, hypertension

B) Prescribe fibrates; TC < 180 mg/dL, HDL-C > 50 mg/dL, LDL-C < 120 mg/dL; Monitor lipid profile every 6 months; Three risk factors: smoking, hypertension, age

C) No intervention needed; TC < 250 mg/dL, HDL-C > 30 mg/dL, LDL-C < 130 mg/dL; Monitor lipid profile annually; Four risk factors: smoking, hypertension, age, family history

D) Recommend lifestyle modifications; TC < 220 mg/dL, HDL-C > 60 mg/dL, LDL-C < 150 mg/dL; Monitor lipid profile every 2 months; One risk factor: smoking

Answer :

For Monty's lipid profile, the appropriate treatment plan would be to prescribe statin therapy to help lower his LDL cholesterol level and reduce his overall cardiovascular risk. The goal lipid levels for Monty are (a) Prescribe statin therapy; TC < 200 mg/dL, HDL-C > 40 mg/dL, and LDL-C < 100 mg/dL.

To monitor the effectiveness of the treatment plan, Monty's lipid profile should be checked every 3 months. This frequent monitoring allows for adjustments to the treatment regimen if necessary and ensures that his lipid levels are within the target range.

Monty has two risk factors for coronary artery disease: smoking and hypertension.Statin therapy is recommended for patients with elevated LDL cholesterol levels, especially those with additional cardiovascular risk factors, such as smoking and hypertension, like Monty. The goal lipid levels aim to reduce his overall cardiovascular risk and improve his lipid profile. Regular monitoring of lipid levels is essential to assess the effectiveness of the treatment plan and make any necessary adjustments. Option (a) accurately addresses Monty's lipid profile, treatment plan, monitoring, and risk factors.

Correct option: a) Prescribe statin therapy; TC < 200 mg/dL, HDL-C > 40 mg/dL, LDL-C < 100 mg/dL; Monitor lipid profile every 3 months; Two risk factors: smoking, hypertension

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