Endocrinology Question 5 Instructor

A 40 year-old man, Maurice LeBlanc, has his lipids checked for the first time. He has no significant past medical history, but a positive family history of early CAD.

LDL-cholesterol 6.8 mmol/L
Total cholesterol 8.8 mmol/L
Triglycerides 1.1 mmol/L
HDL-cholesterol 1.5 mmol/L

What is the lipid abnormality?

Elevated LDL cholesterol.

List three physical (non-vascular) signs that should be looked for.

  • Arcus (circus) cornealis
  • Xanthelasmata
  • Tendinous xanthomata

(NOT eruptive xanthoma, nor lipemia retinalis which are seen with high triglycerides)

List 3 potential primary causes and 3 secondary causes for this lipid abnormality.


  • Polygenic hypercholesterolemia
  • Familial hypercholesterolemia
  • Familial combined hyperlipidemia


  • Hypothyroidism
  • Biliary cirrhosis
  • Nephrotic syndrome
  • Anorexia nervosa
  • Drugs:
    • carbamazepine
    • cyclosporine

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