Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents for evaluation of severe hypertriglyceridemia (TG > 500-1000 mg/dL). Review of systems positive for: [ ] abdominal pain/pancreatitis symptoms, [ ] eruptive xanthomas, [ ] lipemia retinalis, [ ] polyuria/polydipsia. History significant for: [ ] poorly controlled DM2, [ ] alcohol use disorder, [ ] metabolic syndrome, [ ] familial chylomicronemia syndrome. Current medications: [ ] thiazides, [ ] beta-blockers, [ ] estrogens, [ ] corticosteroids.
Clinical Examination Findings
General: Patient appears [ ] well-appearing / [ ] in acute distress. Skin: [ ] Eruptive xanthomas noted on extensor surfaces/buttocks. HEENT: [ ] Lipemia retinalis observed on funduscopic exam. Abdomen: [ ] Soft, [ ] non-tender / [ ] tender to palpation, [ ] hepatosplenomegaly present. Extremities: [ ] No edema, [ ] peripheral pulses intact.
Treatment Protocol
Plan: 1. Lifestyle: Strict low-fat diet (<15% of total calories), alcohol cessation, weight loss. 2. Pharmacotherapy: Initiate [ ] Fibrates (Fenofibrate), [ ] Omega-3 fatty acids (high dose), [ ] Statins (if concomitant ASCVD risk). 3. Monitoring: Repeat fasting lipid panel in [ ] 4-6 weeks. 4. Complication management: Monitor amylase/lipase if abdominal pain occurs.