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Step 1: View clinicals

A 39-year-old man who is otherwise healthy undergoes a routine health screening. His fasting lipid profile is as follows: Total cholesterol: 102 mg/dL (< 200) Triglycerides: 372 mg/dL (< 150) HDL: 68 mg/dL (> 60) LDL: 31 mg/dL (< 100) His father died at the age of 58 from an acute myocardial infarction. There is no family history of inherited dyslipidemias, diabetes, or metabolic syndrome. He is a firefighter by occupation, with an active lifestyle. He does not smoke, only drinks socially, and is currently not on any medications. His fasting blood glucose levels are 86 mg/dL (normal: 70-100), on the same routine screen.

Step 2: Order all relevant investigations

Ultrasound abdomen

The ultrasound of the abdomen appears normal; there is no evidence of a fatty liver.

Renal profile

The renal profile is within normal parameters.

Liver profile

The liver profile is within normal parameters.

Repeat lipid profile

Total cholesterol: 110 mg/dL (<200) Triglycerides: 335 mg/dL (<150) High-density cholesterol: 62 mg/dL (>60) Low-density cholesterol: 43 mg/dL (<100)

Step 3: Select appropriate management

Dietary modifications
Cardiology referral

Score: ★★☆