Dennis is a 58-year-old man you follow in your practice with hypertension and hyperlipidemia.  His BMI is 40, his last fasting blood sugar was 111, and he meets criteria for metabolic syndrome.  You have recommended that he start on a statin but he is not sure he wants to do so as “Everybody says it’s causing diabetes.  I’ve got enough problems without taking a medicine that’s going to make me have more problems”.  You have been following him for at least 3 years and he has yet to lose any weight or change dietary practices.  What is your best response?

What is a contraindication for statin therapy?

Rachel is a 26-year-old who is in for her annual wellness screen. PMH: fibromyalgia, poorly differentiated rheumatoid arthritis. Family history:  Both parents with hypertension, hyperlipidemia and Mom has diabetes.  She is not a smoker and rare alcohol use.    Her FLP reveals a total cholesterol of 250, HDL of 50, LDL of 210, triglycerides of 150.  What would be your recommendation?

Jerry is a patient in your practice with hyperlipidemia.  Recent labs reveal the need for statin therapy.  His baseline ALT is 46 (normal 7-56).  When you do follow up labs, his lipids are greatly improved but his ALT is now 60.  What is the best plan of care?

(10 points) Find the LU factorization of the matrix. Be sure to explain how you solved it and identify the steps and parts.

(10 points) Let

(3 points) What is the minimum value of subject to if A = ? Hint, find the eignevalues. Be sure to explain how you solved it.  0  -3  3  -7  7

(10 points) Find the least squares solution of Ax = b by A) constructing the normal equation for

(5 points) Compute the determinant of the following by cofactor explanation along the second column.  

The nurse is caring for a client receiving chemotherapy who has a white blood cell count (WBC) of 3,900/mm The nurse should teach the client to avoid contact with which family member?