Adult-Gero Best Rated Series.

d. Diabetes mellitus Diabetes mellitus Rationale: In determining whether a patient should be treated for hyperlipidemia, a patient's risk factors must be determined. After assessing fasting lipids, specifically LDLs, CHD equivalents must be identified. These are diabetes, symptomatic carotid artery disease, peripheral artery disease, abnormal aortic aneurysm, and multiple risk factors that confer a 10 year risk of CHD 20%. Major CHD risk factors are elevated LDL cholesterol, cigarette smoking, hypertension, low HDL cholesterol, family history of premature CHD [in male first degree relatives (FDR) 55years; female FDR, 65 years] , and age (men ≥ 45 years, women ≥ 55 years). Patients with 2 or more risk factors should have a 10 risk assessment performed and treated accordingly. A patient will be screened for hyperlipidemia via a serum specimen. He should be told: a. to fast for 12 to 14 hours b. to fast for 6 to 8 hours c. that black coffee is allowed d. a non-fasting state will not affect the results to fast for 12 to 14 hours Rationale: Serum total and HDL cholesterol can be measured in fasting or non-fasting individuals. There are very small and clinically insignificant differences in these values when fasting or not. The primary effect of eating on a patient's lipid values is on the triglyceride levels. The maximum effect of eating on triglyceride levels occurs at 3 to 4 hours after eating, but there may be several peaks during a 12-hour period. Therefore, the most accurate triglyceride levels will be obtained following a 12-hour fast. A 65-year-old male patient has the following lipid levels: Total cholesterol = 240 mg/dL LDL = 140 mg/dL