Toxicology USMLE Step 1 Practice Question
A 76-year-old woman with heart failure and atrial fibrillation taking digoxin presents with nausea, vomiting, and yellow-green halos around lights. Vitals: BP 128/76, HR 102 with frequent ectopy, RR 18, SpO2 98% on room air. ECG demonstrates multifocal premature ventricular contractions. Serum digoxin level is 3.2 ng/mL (therapeutic: 0.5–2.0 ng/mL); potassium is 5.8 mEq/L. She denies chest pain. Which treatment is most appropriate for severe digoxin toxicity?
Answer choices
- ADigoxin-specific antibody fragmentsCorrect answer
- BAtropine only
- CCalcium gluconate alone
- DMethylene blue
- EProtamine sulfate
- FHemodialysis with potassium supplementation
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