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NBME 18 Answers

nbme18/Block 3/Question#46 (reveal difficulty score)
45 yo man for annual health maintenance ...
Fenofibrate πŸ” / πŸ“Ί / 🌳
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 +18 
submitted by βˆ—jambo2222(33),
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I’ts na seocrotmosa.a mcSraao = omsuhoeanetg em.ts stI’ ni eht egsl so kinht owh a VDT osge ot glu.n mSea e.adi


 +9 
submitted by βˆ—dorsal_vein(41),
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anMy edsnttsu lwli get isht tosinuqe wonrg ubeaesc of a iasmrli unteisqo on ol.rUdw iTsh itantpe sha na yteeemrlx ghih lieigeytcrrd lelev dan sah no sroyith of rcidruaoslaacv deesa.si eFartsbi dlsouh eb pbeiesrcdr to pevrnet rtt.eapicnisa

lokotriene  Not sure which UW questions you're referring to, but I found a couple that agree/support Fibrates for lowering isolated triglyceride elevation incase anyone wants to reference them for clarity. #11844 & #166 +  
username  Talking about in situations where the patient has cardiovascular event, serum lipid values show OKAY cholesterol levels but increased triglycerides. Q will ask what to add to patient's regiment. In this case, if answer choice throws you fibrates, you'll want to bite, but if patient has cardiovascular disease, you're going to want to go with statins +2  



 +1 
submitted by βˆ—mariame(15),
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mariame  So this patient has high TOTAL colesterol and TRIGLYCERIDES. Statin may be a choice because its first line therapy for cholesterol reduction. However in this case the patient has very high Triglycerides and first line therapy for Hypertrigliceridemia are Fibrates How to rule out Simvastatin: statins are used to lower LDL not Total cholesterol so use LDL equation -> LDL= Total cholesterol- HDL - (TGS/5) I'll post it here in case anybody has scrambled comments like me. +  



 +0 
submitted by βˆ—donttrustmyanswers(70),
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 +0 
submitted by βˆ—feliperamirez(36),
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icAdncgor ot het AAH veyre neptait ihwt GT obvea 005 sdlhuo vreciee bi,tsfrea vnee hughot aintsts cna rdsaceee GT eevl.ls




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