3 Months Of Insomnia in Medicine / Internal Medicine — 67yo Man | Endocrinology | SMLE Q#12303

SMLE Question #12303

Medicine / Internal Medicine Endocrinology

Objective: OBJ-ADDISON-DOSE-1

Last updated: February 2026
A 67-year-old man presents with 3 months of insomnia, irritability, and palpitations. He has hypertension, major depressive disorder, and chronic atrial fibrillation. Medications are amiodarone, fluoxetine, and enalapril. Examination shows an irregularly irregular pulse without tremor, thyroid enlargement, or eye findings. What is the most appropriate next step?

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