BOF: 3.63
A 62-year-old male is admitted with breathlessness. On
examination he has bilateral ankle oedema and sacral oedema. His pulse rate is
120 beats per minute irregularly irregular. His jugular venous pressure is
raised to the level of his ear lobe and the dominant wave is a V wave. The
apex beat is displaced to the 6th left intercostal space anterior
axillary line, it is thrusting in nature and there is a pan systolic murmur at
the apex, which radiates to his axilla. Auscultation of the lung bases reveals
bilateral basal crepitations. The liver is enlarged 3 fingerbreadths below the
coastal margin and it is pulsatile.
The patient has a fasting sample of blood analysed and
his fasting venous plasma glucose is 6.8 mmol/L. He has an oral glucose
tolerance test and this excludes overt diabetes mellitus.
In this patient treatment with which one of the following
drugs will prevent progression to diabetes mellitus?
a)
Metformin
b)
Gliclazide
c) Pioglitazone
d)
Angiotensin converting enzyme inhibitor
e)
Beta blocker
