A 60-year-old man comes to the office for coronary artery disease, diabetes mellitus type 2 and hyperlipidemia follow up. He is taking low dose aspirin,atorvastatin, metformin, and sitagliptin. His glomerular !ltration rate (GFR) is 22 ml/minute (Normal > 60 ml/minute). Which of the following medication should be discontinued?
سؤال مجاني 5 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: C. Metformin
With GFR 22 (<30), metformin must be discontinued because of the risk of lactic acidosis from accumulation (it is excreted unchanged by the kidney). Sitagliptin can be continued with dose adjustment, and aspirin/atorvastatin are needed for his coronary disease.
ليش كل خيار صح أو غلط
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A
ليش غلط
He has coronary artery disease, and daily aspirin is advised for secondary prevention in existing ASCVD.
✓ Step Up To Medicine 6th Edition 2024 (DM).pdf · p. 3 -
B
ليش غلط
A statin is given when ASCVD risk is elevated; with coronary disease atorvastatin is continued.
✓ Step Up To Medicine 6th Edition 2024 (DM).pdf · p. 3 -
C
ليش صح
Metformin should be avoided when eGFR is below 30; his GFR is 22.
✓ Step Up To Medicine 6th Edition 2024 (DM).pdf · p. 6 -
D
ليش غلط
The slides give no eGFR cut-off for DPP-4 inhibitors; their listed drawbacks are nausea, infection risk and use in HF, unlike metformin's cut-off at eGFR 30.
✓ RT - DM.pdf · p. 10
- المصدر
- RT - DM.pdf · p. 10
Step Up To Medicine 6th Edition 2024 (DM).pdf · p. 6 - المحاضرة
- Diabetes Mellitus · Endocrinology · Module B
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- Endo bank