Internal Medicine

0521779407-09 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:13

742 Hypercholesterolemia

Hypercholesterolemia.................................

FREDRIC B. KRAEMER, MD

history & physical

History

■diabetes

■obesity

■myocardial infarction

■stroke

■peripheral vascular disease

■hypertension

■smoking

■alcohol use

■estrogen or steroid use

■family history of diabetes

■family history of hypertriglyceridemia or hypercholesterolemia

■family history of myocardial infarction

■family history of stroke

■family history of peripheral vascular disease

Signs & Symptoms

■may be asymptomatic

■presentation:

➣symptoms: angina, myocardial infarction, stroke, claudication

➣signs:

tendinous or tuberous xanthoma, xanthelasma, arterial bruits,

decreased pulses

tests

Laboratory

■basic blood studies:

➣fasting lipid panel: elevated total cholesterol, LDL cholesterol

elevated, triglyceride normal or elevated, HDL cholesterol low,

normal or elevated

➣glucose, HgbA1c

➣thyroid function tests

■basic urine studies:

➣proteinuria

ECG