 Hey guys, my name is Boris. I'm a physician assistant. Today is going to be day 10 of our PANS review, physician assistant national certifying exam review, where we pick a note card at random from my very thick stack of PANS review note cards that I personally use to study for the PANS. Today our note card is our question is treatment for hyper triglyceride emia. Your patient has high triglycerides. What is your treatment? Give you guys a few seconds to think of an answer. And also I'm just going to preface this with saying there are basically three different levels of hyper triglyceride emia, which you need to be concerned with as far as treatment goes. So think of three different answers based on the levels of treatment for hyper triglyceride emia. So triglyceride level of 150 to 199, 150 to 199. The treatment is lifestyle, lifestyle modifications, diet modifications. The main one, this is not for the PANS, but from personal experience, the main one is cutting out soda and other sweetened beverages. Whenever I saw high, high, like crazy high triglyceride numbers, it was almost always somebody who consumed soda on a regular basis and quitting that one habit dropped their triglyceride levels pretty damn substantially. So the very first treatment for hyper triglyceride emia of a lower level between 150 and 199 is lifestyle. Cut out processed foods, cut out sugar, added sugar, cut out soda, cut out desserts, you know, anything with sugar and fat or just simple sugar. In there, cut that out lifestyle modification for triglyceride level of 150 to 199. 200 to 499, so 200 to basically 500, the treatment is going to be lifestyle in addition to medications. So first choice for just straight up hyper triglyceride emia is going to be a fibrate, such as a phenofibrate. Okay. Second choice would be statin and of course could be both. So second choice, once your triglycerides are quite high between 200 and 500, now you're doing lifestyle, you're cutting out soda, you're cutting out added sugars, you're cutting out, you know, simple fats, processed foods, and you're also probably adding a medication such as a fibrates or possibly a statin. And then third level, that's a triglyceride level over 500, so 500 and above, it's definitely medications at that point. So a fibrate, possibly a statin, possibly also niacin and omega three supplementation. So a combination of any of those that's going to be provider dependent, but triglycerides over 500, now you're way above just straight up lifestyle modification, now you basically need to add a medication starting with usually fibrates, second choice would be statins, third choice would be niacin, and fourth choice would be omega three supplementation. All right. So again, the question is, what is the treatment for hyper triglyceride emia? And it's going to be between 150 and 199 lifestyle modifications, diet modifications, exercise between 200 and 500. It's going to be lifestyle plus consider a medication such as a fibrate or a statin. And then above 500, you're definitely considering a medication such as a fibrate or statin or possibly niacin or omega three supplementation. See you guys in the next video.