USMLE Forum Archives - USMLE Step 3 - int med
int med
bingousmle - 07-18-10 00:26
A 61-year-old woman is seen in cardiology clinic for evaluation of a new-onset cardiomyopathy. She has had diabetes and has been managed with glipizide 5 mg twice daily and metformin 1000 mg twice daily. At her initial visit, she was noted to have fasting triglycerides of 565 mg/dL, HbA1c of 8.8, and creatinine of 2.8. Her heart failure was stable, and she had returned to her normal level of functioning. What should be done with her therapy?
A. Continue glipizide and metformin and add an injection of insulin at bedtime
B. Discontinue metformin and substitute pioglitazone
C. Discontinue metformin and substitute rosiglitazone
D. Discontinue metformin and add an injection of insulin at bedtime
E. B or D
bingousmle - 07-18-10 00:26
A 61-year-old woman is seen in cardiology clinic for evaluation of a new-onset cardiomyopathy. She has had diabetes and has been managed with glipizide 5 mg twice daily and metformin 1000 mg twice daily. At her initial visit, she was noted to have fasting triglycerides of 565 mg/dL, HbA1c of 8.8, and creatinine of 2.8. Her heart failure was stable, and she had returned to her normal level of functioning. What should be done with her therapy?
A. Continue glipizide and metformin and add an injection of insulin at bedtime
B. Discontinue metformin and substitute pioglitazone
C. Discontinue metformin and substitute rosiglitazone
D. Discontinue metformin and add an injection of insulin at bedtime
E. B or D
The correct answer and explanation will be available after you answer.
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Re: int med babbu5508 - 07-19-10 01:25 My answer is: e.
i think it shoud be an addition of thiazolidinediones in view of her highly elevated triglyceride levels.....
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