Q- A 46-year-old woman with systemic lupus erythematosus presents to the clinic for follow-up. She takes prednisone daily for 3 months. Her condition is stable and she has no complaints since her last visit 3 months ago. She has smoked a pack of cigarettes daily for 15 years. She said that she is not faithful to her diet and exercise program.
On physical examination, her pulse is 84/min; blood pressure is 140/90, no cardiac or pulmonary abnormalities and no organomegaly.
What is the most appropriate lab test you should order on this visit?
A- Blood glucose and serum lipids
B- Serum thyroid stimulating hormone
C- Blood urea nitrogen and serum creatinine
D- Serum cortisol
Answer and Explanation
This patient has systemic lupus erythematosus (SLE) and has been on prednisone (a glucocorticoid) for 3 months. Prednisone is associated with multiple side effects, including hyperglycemia, dyslipidemia, and hypertension, all of which increase the risk of cardiovascular disease. This risk is compounded by her history of 15 years of smoking and suboptimal adherence to diet and exercise. Regular monitoring of blood glucose and serum lipids is essential to assess and manage these risks.
The correct answer is A
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Hi Dr Yakudu. Can you please clarify your comment. It is obvious that blood sugar needs to be monitored because, as you said, prednisone is glucogenic which means expected increase in serum glucose.
Prednisone, is a corticosteroid and hence a glucogenic..Blood sugar not monitored frequently