Rachel is a 26-year-old who is in for her annual wellness sc…

Rachel is a 26-year-old who is in for her annual wellness screen. PMH: fibromyalgia, poorly differentiated rheumatoid arthritis. Family history:  Both parents with hypertension, hyperlipidemia and Mom has diabetes.  She is not a smoker and rare alcohol use.    Her FLP reveals a total cholesterol of 250, HDL of 50, LDL of 210, triglycerides of 150.  What would be your recommendation?

Tom, a new patient is here to see you today about his recent…

Tom, a new patient is here to see you today about his recent diagnosis of Type 2 diabetes mellitus.  Due to the COVID pandemic and Tom starting to work from home, he has gained 12 pounds in the last year.  The patient weighs 215 pounds and BMI is 37 kg/m2.  Tom asks you about weight loss and what goals he should set.  

Don is a 79-year-old male, with past medical history of obes…

Don is a 79-year-old male, with past medical history of obesity, former cigarette smoker, hypertension, chronic obstructive pulmonary disease, pre diabetes, glaucoma, and hyperlipidemia.  You are seeing him for the first time in clinic today and review his medication list.  Which medications should be stopped according to the guidelines? Metformin (Biguanide) 1000 mg BID Lipitor (Statin) 40 mg daily Advair (Inhaled glucocorticoid and Long acting beta-2-agonist) 1 inhalation by mouth twice daily Nadolol (Non selective beta blocker) 40 mg daily  

Mr. Jackson is a 45-year-old you recently started on an anti…

Mr. Jackson is a 45-year-old you recently started on an antihypertensive.  He is a non-smoker.  You see him for follow up one month after beginning therapy.  His only complaint is a dry cough since starting the medication.  This is most likely a side effect of a(n):

Jerry is a 58-year-old male, with past medical history of ty…

Jerry is a 58-year-old male, with past medical history of type 2 diabetes, hypertension, hyperlipidemia, glaucoma, gout, HF, and peripheral neuropathy.  He takes Metformin, Trulicity (GLP1RA), Humalog (rapid acting insulin) and Lantus (basal insulin).  Jerry presented initially about 1 week ago and saw your collaborating physician in clinic with abdominal pain, nausea and vomiting.  Labs were drawn, below are the results: Na        138 mmol/L  (135-145) K           4.2 mEq  (3.5-5.0 mEq) Cr          1.01 mg/dL  (0.8-1.3) eGFR     >60 mL/min/1.73m2 Cl           101 mEq/L  (97-110) CO2       26 mmol/L  (22-32) Lipase     560 U/L (10-140) Based on the above subjective and objective findings, what is your plan of care?

Jerry is a patient in your practice with hyperlipidemia.  Re…

Jerry is a patient in your practice with hyperlipidemia.  Recent labs reveal the need for statin therapy.  His baseline ALT is 46 (normal 7-56).  When you do follow up labs, his lipids are greatly improved but his ALT is now 60.  What is the best plan of care?