Answer: C − The patient is showing signs of hypothyroidism as evidenced by the high TSH and low resting heart rate. A1c is within acceptable range as is the blood pressure. The dose of levothyroxine should be adjusted.

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FPGEE Foreign Pharmacy

Category - Clinical

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A 56-year-old male patient has diagnoses of essential hypertension, hypothyroidism, and Type II diabetes of 5 years duration. Medications include metformin, glyburide, levothyroxine, and atenolol. Recent labs report an A₁c of 5.8%, TSH of 31.7, Hgb of 6.3. A physical exam reveals a blood pressure of 128/76 and a resting heart rate of 58. Which of the following medications may need adjustment?

I. Levothyroxine
II. Atenolol
III. Metformin

I and II only
II and II only
I only
I and III only

Explanation

Answer: C − The patient is showing signs of hypothyroidism as evidenced by the high TSH and low resting heart rate. A₁c is within acceptable range as is the blood pressure. The dose of levothyroxine should be adjusted.

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