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Lithium toxicity — ABEM Board MCQ

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ModerateToxicologyLithium toxicityABEM Board

A 62-year-old woman taking lithium arrives with vomiting, tremor, and confusion after starting an ACE inhibitor. Triage acuity is ESI 2; BP 118/64 mm Hg, HR 96/min. She has coarse tremor, ataxia, hyperreflexia, and creatinine 2.0 mg/dL. Lithium level is elevated. Which of the following is the most likely diagnosis?

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Correct answer: E — Lithium toxicity

GI symptoms, tremor, ataxia, confusion, renal impairment, and elevated lithium level indicate lithium toxicity.

Reference: ACMT lithium poisoning guidance