There is usually nothing to find on examination. Recognition is therefore an exercise in assembling history and laboratory data rather than eliciting physical signs. The pattern is built from: - elevated LDL cholesterol - elevated non-HDL cholesterol - elevated triglycerides - diabetes - hypertension - smoking - chronic kidney disease - known atherosclerotic cardiovascular disease - family history, particularly premature vascular disease in a first-degree relative Severe or familial disease occasionally does declare itself physically. Look for: - tendon xanthomas, classically in the Achilles tendon or the extensor tendons of the hand - xanthelasma around the eyelids - premature corneal arcus, which is significant in a younger adult but an unremarkable finding in old age These signs are uncommon, but finding one substantially changes the clinical picture and should always be documented and communicated. Absence of symptoms does not mean absence of vascular disease risk. For NCLEX-RN (United States), items rarely announce the topic in the first sentence. Anchor to objective data, trajectory, and the safest next step for the role named in the stem before distractors compete. On the...