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Clinical Synthesis Case Study

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Clinical Synthesis/ Critical Analysis: This is a 35 y/o WM who has a PMH of hypercholesterolemia x 6 months. Because he moved out of state, he was lost to follow-up. He was not treated with any pharmacologic agents at that time. Instead he attempted lifestyle modifications, including diet and exercise. Once he returned to the state he came in for a wellness exam. His physical examination was unremarkable, however upon evaluation of his diagnostic labs his total cholesterol was 348mg/dL, triglycerides 237 mg/dL, VLDL 47 mg/dL and LDL 227 mg/dL; all were elevated. According to literature, his history and labs define a classic case of clinical FH. Not all patients have a physical manifestation of the disorder, such as the presence of tendon xanthomata, …show more content…
According to current literature and internationally accepted criteria established by the US MEDPED (Make Early Diagnosis to Prevent Early Death), UK (Simon Broome) and the Dutch Lipid Clinic3, a person who has a total cholesterol of greater than or equal to 310mg/dL are qualified for genetic testing in hopes of finding a mutated gene. For this particular patient, it would have been significant to do this as he has a child and plans on having more. For the sake of his future family, it would benefit him to follow through with cascade genetic …show more content…
This would benefit not only his personal health but also the health of his future family. These adverse effects include early death, myocardial ischemia, aortic stenosis, CABG in the early 20’s and a possible cardiac transplant3-5. In addition to explaining the potential side effects of untreated FH, it is equally important to emphasize adhering to a heart healthy diet and lifestyle whereby he limits his daily fat intake and increases his daily exercise. This, in supplementation with a return follow-up visit in three months to re-check is liver and cholesterol levels, would suffice for current management of this patient’s

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