What is A young male patient presents with LDL 600 mg/dl, triglycerides 160 mg/dl. What would be the most likely finding on physical examination? and explain in detail?
Ans. is 'a' i.e. Tendon xanthomas Increased LDL cholesterol and triglycerides in the normal range suggests the diagnosis of hypercholesterolemia.These disorders are characterized by mutation in the L.D.L. receptors.Most patients presents with cutaneous xanthomas on the hands, wrists, elbows, knees, heels or buttocks.Arcus cornea is present and some patients have xanthelasmas.Total cholesterol level is usually > 12.93 mmol/L (500 mg/dl) and can be > 25.86 mmol/L (1000 mg/dl).The triglyceride level is usually normal.NoteNorma L.D.L.Desirable - < 130 mg/dlBorderline high - 140-160 mg/dlHigh risk - > 160 mg/dlNormal triglyceridesDesirable - 150 mg/dlBorderline high - 150-200 mg/dlHigh - 200-500 mg/dlThe most common physical feature to look for in these patients is "tendon xanthomas".They may also show xanthelasmas but,Tendon xanthomas are pathognomonic for hypertriglyceridemia