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Primary prevention lipid management — USMLE Step 3 MCQ

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ModerateAmbulatory Medicine / Primary CarePrimary prevention lipid managementUSMLE Step 3

A 50-year-old man comes for an annual visit. He has obesity, a father who had myocardial infarction at age 54, and blood pressure of 132/78 mm Hg. LDL cholesterol is 168 mg/dL, HDL is 38 mg/dL, triglycerides are 190 mg/dL, and 10-year ASCVD risk is 8.5%. Which of the following is the most appropriate next step in management?

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Correct answer: D — Begin moderate- to high-intensity statin therapy

Adults aged 40-75 with LDL 70-189 mg/dL and elevated ASCVD risk should receive statin therapy; risk enhancers such as family history and LDL near 160 further support treatment.

Reference: ACC/AHA Cholesterol Guideline; USPSTF Statin Use Recommendation