12-05-2009, 02:28 PM
A 42-year-old man comes to the physician for
a routine follow-up examination. He has a
15-year history of type 1 diabetes mellitus and
an 8-year history of hypertension. Current
medications include insulin, lisinopril, and
hydrochlorothiazide. He is 173 cm (5 ft 8 in)
tall and weighs 68 kg (150 lb); BMI is
23 kg/m2. His pulse is 80/min, and blood
pressure is 124/74 mm Hg. Examination of the
lower extremities shows hair loss over the
shins. No other abnormalities are noted. His
hemoglobin A1c is 6.3%. Which of the
following is most appropriate to reduce
diabetic complications in this patient?
(A) Reduction of systolic blood pressure
to less than 120 mm Hg
(B) Annual ophthalmologic examination
© Annual exercise stress test
(D) Add metformin to the regimen
(E) Switch from lisinopril to atenolol
a routine follow-up examination. He has a
15-year history of type 1 diabetes mellitus and
an 8-year history of hypertension. Current
medications include insulin, lisinopril, and
hydrochlorothiazide. He is 173 cm (5 ft 8 in)
tall and weighs 68 kg (150 lb); BMI is
23 kg/m2. His pulse is 80/min, and blood
pressure is 124/74 mm Hg. Examination of the
lower extremities shows hair loss over the
shins. No other abnormalities are noted. His
hemoglobin A1c is 6.3%. Which of the
following is most appropriate to reduce
diabetic complications in this patient?
(A) Reduction of systolic blood pressure
to less than 120 mm Hg
(B) Annual ophthalmologic examination
© Annual exercise stress test
(D) Add metformin to the regimen
(E) Switch from lisinopril to atenolol