Test your medicine knowledge: 58-year-old man with type 2 diabetes
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 58-year-old man is evaluated during a routine appointment. He is asymptomatic. He was diagnosed with type 2 diabetes mellitus 4 years ago and has hypertension, dyslipidemia, and obesity. His medications are enteric-coated low-dose aspirin, lisinopril, fluvastatin (20 mg/d), and metformin.
His calculated 10-year risk of atherosclerotic cardiovascular disease (ASCVD) using the Pooled Cohort Equations is 10%.
On physical examination, blood pressure is 126/78 mm Hg and pulse rate is 72/min. The remainder of the examination is normal.
Laboratory studies show total cholesterol 186 mg/dL (4.82 mmol/L), LDL cholesterol 123 mg/dL (3.19 mmol/L), HDL cholesterol 44 mg/dL (1.14 mmol/L), and triglycerides 109 mg/dL (1.23 mmol/L).
Which of the following is the most appropriate statin management?
A. Increase fluvastatin to 40 mg/d
B. Switch to atorvastatin, 40 mg/d
C. Switch to lovastatin, 20 mg/d
D. Switch to pravastatin, 20 mg/d
E. Switch to simvastatin, 10 mg/d
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Source: Kevin, M.D. - Medical Weblog - Category: Journals (General) Authors: mksap Tags: Conditions Diabetes Heart Source Type: blogs
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