A 65-year-old man presents to your primary care office with pain in his right lower leg and is concerned about a possible blood clot. On examination, there is tenderness with palpation over the left calf muscles. His medical history includes hypertension, hyperlipidemia, and depression. Current medications are lisinopril, clonidine, rosuvastatin, sertraline, and aspirin. Before proceeding with investigations for a possible clot, you consider whether any of his medications might be contributing to his leg pain. Which medication is most likely responsible for his symptoms?
A 64-year-old female comes to your office to establish care. When asked about her current medications, she reports taking lisinopril and metformin but mentions discontinuing a cholesterol medication because it caused an upset stomach and a fishy odor to her breath. Which of the following medications is she most likely referring to based on these adverse effects?
A 70-year-old male comes to your primary care center for the management of his hypertriglyceridemia. His medical history is significant for hypertension, diabetes and coronary artery disease. His current medications include aspirin, lisinopril, insulin and rosuvastatin. His current triglyceride level is 498 mg/dL. Of the following, which medication can lower his triglycerides and decrease the risk of future cardiac events?
A 56 year-old male comes to your office for the management of his very high LDL levels. He has been taking a statin for a few years but his LDL levels have not come down to a desired level. You decided to add a fibrate to his treatment regimen. Of the following, which is the most concerning adverse effect to be monitored when you add a fibrate to a statin?
A 39 year-old woman comes to your primary care center complaining of right upper quadrant abdominal pain, indigestion and nausea. She has been taking warfarin for a recent deep venous thrombosis in right lower extremity. Family history reveals that several members of her family, including her mother and a sister, suffer from an inherited metabolic disorder. On physical examination you notice yellowing of the skin and eyes; moderate hepatosplenomegaly; tenderness in the right upper quadrant, epigastric area and middle quadrant. You also notice small, nonpainful orange-red papules on his scalp, elbows and knees and a yellow-to-orange coloration of palmar and finger creases. Laboratory tests reveal elevated amylase, lipase; elevated triglyceride level of 1700 mg/dL; elevated VLDL, and elevated total cholesterol. Abdominal ultrasound revealed stones in the gallbladder. Patient was admitted to the local hospital and had a cholecystectomy. At the time of her discharge, you begin her on a triglyceride-lowering agent. Which of the following is the first-line treatment to treat this patient’s hypertriglyceridemia?
