A 54-year-old man is brought to the emergency department bec

[meenaxi]

A 54-year-old man is brought to the emergency department because of a 2-week history of progressive shortness of breath with exertion and leg swelling. He now requires two pillows for sleeping because of shortness of breath when lying flat. He has had a 4.5-kg (10-lb) weight gain during this period. He has a 15-year history of type 2 diabetes mellitus and hypertension that are poorly controlled despite treatment with a variety of medications. Two months ago, he began receiving a new diabetic medication that has been titrated upward during the past month. Crackles are heard at the lung bases bilaterally. Cardiac examination shows an S3 gallop. There is 2+ peripheral edema of the lower extremities. Which of the following medications is the most likely cause of the new symptoms in this patient?

A ) Acarbose

B ) Glyburide

C ) Metformin

D ) Repaglinide

E ) Rosiglitazone

[meenaxi]

Answer is E.

All medicine mentioned are used for treating type 2 diabetes mellitus Main side effects of sulfonylureas [as they increase insulin] will me marked hypoglycemia fainting so b is out,Repaglinide can be safely given in heart patients so D is out Acarbose alpha glucosidase inhibitor main side effects are abdominal pain,diarrhea flatulence,

Well Metformin and Rosiglitazone both can cause weight gain,and congestive heart failure as seen .While rosiglitazone also reponsible for edema so answer might be E.