solved

James, a 46 year old Hispanic man, new patient, insured
Subjective:
CC: presents for a routine PE for his new job and to establish care.
HPI: Currently he does not have any complaints. He has not had a PCP for years, as he just recently has been able to obtain health insurance.
PMH: He has no hx of chronic illnesses
Meds: None, no OTC or herbal
Allergies: NKDA, food or enviornmental
PSH/PH: No hx of hospitalizations or surgeries.
FH:
Mother: 2 MI’s first at age 60, HTN.
Father: unk med hx
Brother: Type 2 DM and obesity.
MGM: deceased age 80
MGF: deceased age 74 COPD
PGM; unknown
PGF: unknown
Social hx: He is married with 2 grown children and is starting a new job as a salesman. Frequently eats at fast food restaurants, sedentary lifestyle due to frequent traveling, moderate ETOH use. Denies smoking, drug use.
ROS: no pertinent Positives
Objective:
VS: T 98.8, HR 88, R 16, BP 144/90 (confirmed with repeat measurements after 5 minutes of rest between readings), Wt 237 lbs, Ht 68 in, BMI 36, waist circumference 44 in.
Complete PE performed and no abnormalities discovered.
EKG: NSR.
Urinalysis: dip negative.
He returns one week later for results of his lab work, which are:
Total Cholesterol 282
HDL 36
TG 248
LDL 152
Glucose 102
Electrolytes normal
Renal and liver functions normal
CBC normal
What is your diagnosis of this patient and why? Discuss, the diagnostic (test and physical exam) findings consistent with your diagnosis. Are there other studies that you would consider for this patient and why?
What would be your therapeutic management plan for this patient and why, are there other options?

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