Severe hypertriglyceridaemia — SCE Endocrinology MCQ

Correct answer: C — Acute pancreatitis treatment with glycaemic and triglyceride management

The best answer is “Acute pancreatitis treatment with glycaemic and triglyceride management”. Severe hypertriglyceridaemia is a plausible pancreatitis driver and uncontrolled diabetes is an important reversible cause; acute care requires fluids, analgesia, glycaemic management and specialist-directed triglyceride reduction rather than routine LDL therapy. “Start ezetimibe alone and discharge after pain improves” is less appropriate because ezetimibe targets LDL cholesterol and is not adequate acute management of pancreatitis with triglycerides at this level “Use a bile-acid sequestrant as the first triglyceride-lowering drug” is less appropriate because bile-acid sequestrants can raise triglycerides and are inappropriate here “Reassess fasting lipids after the pancreatitis has resolved” is less appropriate because the immediate pancreatitis and metabolic risks preclude delayed annual review “Start levothyroxine for presumed secondary hypertriglyceridaemia” is less appropriate because normal thyroid testing provides no indication for thyroid hormone

Reference: Endotext: Pancreatitis secondary to hypertriglyceridaemia. https://www.ncbi.nlm.nih.gov/books/NBK279082/