08-30-2014, 09:17 PM
A 52 year old African-american woman is seen in the office during a regular follow-up visit. Her history is significant for diabetes mellitus and hypertension. She has been suffering from cough over the past two weeks. She feels that there is a tickle at the back of the throat which leads to paroxysms of coughing. Her medications include Aspirin, Glipizide, atorvastatin, enalapril and Hydrochlorthiazide. Enalapril was started 3 weeks ago at a low dose of 5mg/day. On examination, blood pressure is 132/90 mm Hg seated and standing. Her physical examination is normal. Laboratory values reveal a serum creatinine concentration of 1.8mg/dl. Her baseline creatinine 1 month ago was 1.5mg%. Which of the following is not an indication to stop ACE inhibitor?
A) Swelling of the lips and tongue
B) 20% increase in serum creatinine
C) Intractable severe cough
D) Serum potassium of 6.5mmol/L
E) Hypovolemia with shock
A) Swelling of the lips and tongue
B) 20% increase in serum creatinine
C) Intractable severe cough
D) Serum potassium of 6.5mmol/L
E) Hypovolemia with shock