usmle6789
Forum Senior
Topics: 33
Posts: 49
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47 yr old woman came for routine health maintenance examination. She has 10 yr history of type 2 DM well controlled with oral hypoglycemic agent. Her mother died of MI at the age of 38 yrs. Pt weighs 82 kg[180 lbs], 163 cm[64inch] tall. Bp 150/95 mm/hg. On physical examination multiple small skin tags below the eyebrows and on the nose and eyelids seen. Most appropriate next step in diagnosis?
1] measurement of serum FSH level
2] serum lipid studies
3] 24 hour urine collection for creatinine clearance
4] x-ray chest
5] ecg
6] no further studies indicated
my answer is ECG here.
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| tamriko
Forum Elite
Topics: 23
Posts: 296
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What about 3]. 24 hour urine collection for creatinine clearance.She is hypertonic.
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| noelle
Forum Elite
Topics: 59
Posts: 226
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i think lipid studies coz h/o MI in mom , pt is overweight n those skin tags seem like xanthelasmas to me! + DM !
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only strong survive......
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| ELM
Forum Guru
Topics: 28
Posts: 936
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# 2 to me.
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ELM
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| mikyro
Forum Junior
Topics: 0
Posts: 81
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47 yr old woman came for routine health maintenance examination. She has 10 yr history of type 2 DM well controlled with oral hypoglycemic agent. Her mother died of MI at the age of 38 yrs. Pt weighs 82 kg[180 lbs], 163 cm[64inch] tall. Bp 150/95 mm/hg. On physical examination multiple small skin tags below the eyebrows and on the nose and eyelids seen. Most appropriate next step in diagnosis?
1] measurement of serum FSH level
2] serum lipid studies
3] 24 hour urine collection for creatinine clearance
4] x-ray chest
5] ecg
6] no further studies indicated
10 yr history of type 2 DM well controlled with oral hypoglycemic agent
Her mother died of MI at the age of 38 yrs
weighs 82 kg[180 lbs], 163 cm[64inch] tall
Bp 150/95 mm/hg
small skin tags below the eyebrows and on the nose and eyelids seen
Come on guys, this is very simple  :
Why did her mother die at the age of 38 yo of MI :wink: ?
The pt is overwighted, has DM, HTN and markers of increased CT :wink:
So, the next most logical thing to do is 2 8) .
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the same miky - always ready to help my patients and friends as well
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| usmle6789
Forum Senior
Topics: 33
Posts: 49
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you are amazing yaar!!!
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