Dr. Ajeet Singh (Family Medicine) needs a second opinion on this medical case.
A 48 year old obese female presented with complaints of mild edema in legs and weight gain for the past 2 to 3 months.
She is a known case of Hypothyroidism(25mcg) with HTN( Amlokind AT) on medications
Upon examination, his BP was 190/110, Pulse 110/min
Gave her ampoule of lasix and 5mg amlodipine stat
I had started her on Tazloc H OD
Dytor 5mg OD
Vit D3 60k
L thyroxine 25mcg continue until fresh TSH reports
On follow up visit, her ECG is attached,
TSH is 13.85
BP is 130/80mmHg
Uric Acid 7.6
Vit D3 is in insufficient category
B/L chest clear
Hb - 11.8
So now the concerns are -
1) Ideal dose to titrate L thyroxine ?
Considering her weight 85 kgs, dosage should be 125mcg ?
2) She has hyperuricemia, so added furic 40 and change tazloc H to Tazloc AM?
3) Kindly comment on ECG