dr_jojo
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A 30-year-old woman comes to the physician for a follow-up examination 4 months after starting treatment with lithium carbonate; during this period she has had a 3.2-kg (7-lb) weight gain. Her medication was prescribed soon after the birth of her son to treat racing thoughts, increased spending, and overtalkativeness; she has had difficulty sleeping for more than 2 hours nightly. Her symptoms decreased after 2 weeks of lithium carbonate therapy. She continues to take lithium carbonate (300 mg three times daily). Her temperature is 37 C (98.6 F), blood pressure is 120/80 mm Hg, and pulse is 70/min. Examination shows normal findings. The most appropriate next step is measurement of which of the following?
A
) Fasting serum glucose level
B
) Leukocyte count
C
) Serum alkaline phosphatase activity
D
) Serum creatinine level
E
) Serum thyroid-stimulating hormone level
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| dr_jojo
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what if this Q has an option of
check lithium level
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| robin082006
Forum Hero
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E
If symptoms improve and no side effects-->no need to check lithium level (Conrad Fisher)
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| dr_jojo
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When we should check seum creat level
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| eaguin
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e
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| zeloc
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Lithium can affect kidney function too, doesn't the Cr have to be checked too?
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| dr in trouble
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| Ivonne
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| Justice
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| zeloc
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dr in trouble, Ivonne, and Justice, can u explain why the Cr does not have to be checked?
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| radonc
Forum Senior
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The question is asking - why is the pt gaining weight? That's the main crux.
The above scenario highlights the fact that lithium can cause hypothyroidism. And yes, you need to check creatinine also, but that is not being asked here.
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| zeloc
Forum Junior
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Ah, I see, missed that point.
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