Heart failure with preserved ejection fraction — SCE Geriatric Medicine MCQ
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Correct answer: B — Withhold lithium and obtain lithium, renal and electrolyte tests now
Explanation lettering: B = shown as A · E = shown as B · A = shown as D · D = shown as E
E is correct: the clinical syndrome is compatible with lithium toxicity, which may occur despite a previously or even apparently current therapeutic concentration; lithium is withheld, urgent lithium and renal/electrolyte testing obtained, and specialist advice sought. A delays action. B makes an unmonitored partial adjustment. C worsens toxicity. D tests a chronic adverse effect while ignoring an acute poisoning syndrome.
Reference: NHS SPS: lithium monitoring: https://www.sps.nhs.uk/monitorings/lithium-monitoring/