T.A., a 43-year-old premenopausal woman, is screened with a lipid profile during an annual medical..

T.A., a 43-year-old premenopausal woman, is screened with a lipid profile during an annual medical evaluation. She has never taken cholesterol-lowering medication and currently takes only a multivitamin daily. She has had no symptoms of coronary, carotid, or peripheral vascular disease. She has a 20–pack-year history of smoking and exercises four times a week, without physical limitations. T.A. states that she follows a low-fat, low-cholesterol diet. Her father is alive and well at age 71, with a normal cholesterol level. Her mother had an MI at age 47 and died at age 57 from a second event. Her grandfather died of an MI at age 52; a sister has hypercholesterolemia and is taking simvastatin. Pertinent physical findings are weight, 125 pounds; height, 63 inches; blood pressure (BP), 120/82 mm Hg; pulse, 66 beats/minute and regular; carotid pulses symmetric bilaterally without bruits; no neck masses; no abdominal bruit; and no evidence of tendon xanthomas. Pertinent laboratory findings, obtained after a 12-hour fast, show the following results: Total cholesterol, 290 mg/dL TG, 55 mg/dL HDL-C, 55 mg/dL LDL-C, 224 mg/dL Non–HDL-C, 235 mg/dL Plasma glucose, 96 mg/dL Thyroid-stimulating hormone (TSH), 0.92 international units/mL Alanine aminotransferase (ALT), 11 units/L Aspartate aminotransferase (AST), 8 units/L Blood urea nitrogen, 12 mg/dL Creatinine, 1.0 mg/dL Urinalysis, negative What is your assessment of T.A.’s lipid panel results?

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