1. Janice is a 64-year-old black female with a history of diabetes and HTN, currently controlled on metformin 1000mg daily, Lisinopril 20mg daily, and Norvasc 10mg daily. Her most recent labs show cholesterol 360, triglycerides 450, LDL 220, and HDL 60. Her CR is 1.2 and GFR is normal. Her current blood pressure is 150/90. Do you think Janices treatment plan is optimal? What other information would you like to obtain? Discuss how will you guide Janices treatment plan and provide evidence for your rationale.
2. Darren is a 46-year-old African American male with a history of HTN and hypertriglyceridemia. Current medications include ezetimibe 10 mg daily, niacin SR 1,000 mg at bedtime and HCTZ/lisinopril 25/20 mg daily. He complains of lack of energy, core weight gain, and a decrease in erections. Labs reveal testosterone 180 ng/dL (193836 ng/dL) with normal TSH/thyroxine, FSH, LH, and PSA. Is this patient a candidate for testosterone therapy? Why or why not? Which, if any, of his medications are contributing to his symptoms?
3. Tom is 50-year-old male who presents with distal lateral subungual onychomycosis of his left great toe. He has had symptoms for four months. On exam, he also appears to have interdigital tinea pedis. Referring to clinical guidelines, what is the first-line treatment for both tinea pedis and onychomycosis in adults? What medication precautions does the patient need to be educated on? What kind of follow-up does the patient require?
