skip to main content

Digoxin toxicity with arrhythmia — SCE Acute Medicine MCQ

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

HardAcute Cardiac PresentationsDigoxin toxicity with arrhythmiaSCE Acute Medicine

A 83-year-old woman is assessed on the acute medical unit. She takes digoxin and clarithromycin and now has nausea, yellow vision and bradyarrhythmia. Creatinine has risen and ECG shows scooped ST segments with ventricular ectopy. Initial assessment includes relevant observations, bedside tests and urgent blood results. 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: C — Withhold digoxin and check potassium urgently

Withhold digoxin and check potassium urgently is the best answer because digoxin toxicity is likely, and potassium plus renal function determine urgency and antidote need. Give broad-spectrum intravenous antibiotics within one hour is plausible, but it is less appropriate for the physiology or timing described in this stem. The other distractors either fit a neighbouring presentation, delay definitive treatment, or miss the key immediate risk. Clinical pearl: Macrolides can precipitate digoxin toxicity through interaction and reduced clearance.

Reference: BNF; Toxbase