Posted: July 26th, 2016

You!decide!to!order!an!EKG,!which!is!normal.!!Her!labs!reveal!a!normal!blood! glucose level.! ! Her! fasting! cholesterol! is! 270,! LDL! =! 192,! HDL! =! 46.

You!decide!to!order!an!EKG,!which!is!normal.!!Her!labs!reveal!a!normal!blood! glucose level.! ! Her! fasting! cholesterol! is! 270,! LDL! =! 192,! HDL! =! 46.! ! She! inquires!about!further!work%ups!for!her!chest!pain. 6. Please!estimate! her! pre%test!likelihood! of! coronary!artery! disease!in! the! next!10!years,!given!the!above!information,!using!the!Framingham!model! in! the! appendix! of! the! latest! cholesterol! guidelines! published! by! the! National!Cholesterol!Education!program!(*see#reference#below). 7. Using!this!estimate,!show!a!2×2!table!and!calculate!post%test!probabilities! for!an!exercise! treadmill! test.!!(Assume!sensitivity!of!85%!and!specificity! of!85%!for!CAD)!!Is!a!“positive!test”!result!more!likely!to!represent!a!“true! positive”!or!a!“false!positive”?!!Will!you!order!the!test?!Justify. 8. After!attempting!to!lower!her!cholesterol!by!diet!over!the!next!3!months,! she!is!discouraged!because!a!repeat!lipid!panel!is!essentially!unimproved.! Will!you!start!her!on!a!lipid!lowering!medication?!What!does!the!National! Cholesterol!Education! Program! III! (*JAMA,!Vol.! 285,!No.! 19)! recommend! as!a!guideline?!!What!would!you!estimate!the!5%year!NNT!for!a!population! like!her!to!be?