Question

AR is a 46yo African-American male who presents to his doctor with excessive thirst, urination, and hunger for the past 2 months. Other past medical history includes obesity, hypertension, hyperlipidemia, and occasional tension headaches. He is a non-smoker and participates in minimal weekly cardiovascular activity. He is currently taking hydrochlorothiazide 25mg daily, atorvastatin 20mg QHS, acetaminophen 500mg daily PRN pain. Pt denies any drug allergies. His doctor draws fasting labs with the following results: Glucose 168, Scr 1.01, BUN 14, Hemoglobin A1c 7.4, TSH 1.23, Total Cholesterol 208, LDL 165, and HDL 42. Vitals include: BP- 145/83, HR- 78bpm, temp- 98.6, height 65 inches, and weight 85kg. He is diagnosed with type 2 diabetes.

3. The doctor discusses with AR the long term risks of his diabetes for increasing his risk of having a heart attack or stroke. The doctor calculates his Atherosclerotic Cardiovascular Disease Risk score. What is his current cardiovascular 10 year risk? What would be his cardiovascular 10 year risk if risk factors were optimal?

a. 11.4%, 1%

b. 12.9%, 2%

c. 15.4%, 2%

d. 17.6%, 3%

e. 21.3%, 7%

4. At 3 months follow-up, remarkable labs include fasting glucose 157, A1c 7.2. Pt with no problems tolerating current medication. What would be next line therapy?

a. Stop current DM medication

b. Increase dose of current DM medication

c. Add on another oral DM medication from a different class

d. Add short acting insulin after breakfast

5. What may be some common side effects AR may experience with his current DM treatment? Select all that apply.

a. diarrhea

b. stomach discomfort

c. liver dysfunction

d. hypertension

e. neuropathy

Answer 1

12.9% 2%

Add on another oral DM medicine from another class

Stomach discomfort & neuropathy