USMLE® Step 1 style questions USMLE
USMLE® Step 2 style questions USMLE
A 32-year-old woman presents to clinic with deposits in the supraorbital area as seen in the photograph. She states that she developed these skin findings over the past year. She takes no medications, has no diagnosed medical conditions, and does not visit a primary care physician. Family history is positive for her mother having passed away at the age of 50 secondary to a massive myocardial infarction. A lipid panel reveals normal triglyceride levels and a total cholesterol level of 420 mg/dL. In addition to dietary modificationhy, which of the following is the most appropriate treatment for her condition?
Content Reviewers:Viviana Popa, MD
With familial hypercholesterolemia, familial means the disease runs in families, so it has a genetic predisposition, hyper means excess and lastly cholesterolemia refers to the level of cholesterol in the blood.
So, familial hypercholesterolemia is a genetic disorder associated with high levels of cholesterol in the blood.
There are two main types of cholesterol: LDL or Low Density Lipoprotein which is sometimes called “bad cholesterol,” nad HDL or High Density Lipoprotein which is sometimes called “good cholesterol.”
But good and bad is overly simplistic, and like all things - the subtleties matter.
LDL is produced by the liver and it carries cholesterol out to the rest of the body.
If all of the cholesterol from LDL is not completely distributed to the peripheral cells, then HDL brings some of that cholesterol back from the peripheral tissues and sends it to the liver.
That’s why we want to keep LDL blood levels under control.
On the other hand, HDL can remove cholesterol from cells and that can help reverse the process of atherosclerosis.