This is the entirety of the question that was presented to me. Case Histo Panky,

Question

This is the entirety of the question that was presented to me.

Case Histo Panky, age 13, was admitted to hospital at 9:00 AM with suspected acute appendicitis after severe abdominal pain throughout the night. On examination, her temperature and blood pressure were normal, she seemed somewhat underweight, liver and spleen were enlarged she had yellowish eyes, and numerous yellow patches (xanthomas) were seen on her trunk and limbs. A long history of abdominal pain had been ascribed to a “grumbling appendix". A blood specimen had the appearance of creamed tomato soup and after centrifugation, a thick band of "cream" collected at the top. Panky had had nothing to eat for 15 hours. A lipid profile and electrophoresis of plasma lipoproteins were ordered Creamy appearance of blood indicates very high lipids. Determination of the plasma lipids (lipid profile) confirmed hyperlipidemia. The lipids consisted largely of triglycerides, and the cholesterol was also increased. Electrophoresis of plasma lipoproteins confirmed the presence of chylomicrons Plasma lipids (Fasting) Normal range Total lipid: 400-800 mg/dl Triglycerides: 10-190 mg/dl Cholesterol 150-230 mg/dl Panky's result: Total lipid: 3400 mg/dl Triglycerides: 2230 mg/dl Cholesterol: 290 mg/dl

Explanation / Answer

Some forms of primary hypertriglyceridemia can lead to specific symptoms: both familial chylomicronemia and primary mixed hyperlipidemia include skin symptoms (eruptive xanthoma), eye abnormalities (lipemia retinalis), hepatosplenomegaly

Mild to moderate elevations in triglyceride levels are now considered a risk factor for heart disease. If the levels are severely elevated, one risks developing acute pancreatitis. Because of the increased risk of premature coronary disease, fibrate therapy is recommended in patients with hypertriglyceridemia. In addition, changes in lifestyle and reduction of risk factors for heart disease can improve prognosis.

-Low-density lipoprotein (LDL) cholesterol

-very-low-density lipoprotein (VLDL) cholesterol

- triglycerides

-Fasting blood sugar (FBS)

-post-lunch blood sugar (PLBS)

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