skip to main content

Theophylline toxicity — SCE Acute Medicine MCQ

Instant feedback + full explanation. One question, done properly.

ModerateToxicology and OverdoseTheophylline toxicitySCE Acute Medicine

A 42-year-old man presents with collapse, confusion or vomiting after a possible exposure. Relevant history includes medication, recreational or environmental exposure. On assessment, toxidrome features and physiological instability are present. Investigations show vomiting, SVT, hypokalaemia and toxic theophylline level after ciprofloxacin. What is the most appropriate next step in management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Stop theophylline, correct potassium and discuss charcoal or haemodialysis

The key discriminator is that vomiting, SVT, hypokalaemia and toxic theophylline level after ciprofloxacin, which makes Stop theophylline, correct potassium and discuss charcoal or haemodialysis the single best answer. Start anticoagulation after assessing bleeding risk is less appropriate because it does not address the dominant acute risk in the vignette; Arrange urgent CT imaging would fit a different presentation or later stage of care. Start broad-spectrum intravenous antibiotics and Give analgesia and antiemetic therapy are suboptimal because they would either delay time-critical treatment or follow the wrong acute pathway. Teaching point: SCE-style acute medicine questions usually test prioritisation using physiology, timing and a guideline-defined threshold, rather than isolated factual recall.

Reference: TOXBASE; BNF theophylline