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Medication reconciliation at discharge — ABIM Board MCQ

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ModerateGeneral Internal MedicineMedication reconciliation at dischargeABIM Board

A 68-year-old man is discharged after hospitalization for heart failure. His discharge list includes lisinopril 20 mg daily, but his outpatient pharmacy profile still has enalapril from before admission. He is also prescribed potassium chloride. Which of the following is the most appropriate management?

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Correct answer: APerform medication reconciliation and discontinue duplicate renin-angiotensin therapy

Transitions of care are high-risk for medication discrepancies. Medication reconciliation should identify and resolve duplicate ACE inhibitor therapy and potassium-related safety risks before harm occurs.

Reference: AHRQ Medication Reconciliation Patient Safety Resources; Joint Commission National Patient Safety Goals