Question

A Female patient was on lithium for bipolar disorder for 6 months.she fasted for some days due to religious condition and later presented with seizures,tremors, confusion and weakness. What investigations have to be done to diagnose her condition

• A. serum electrolytes
• B. serum lithium
• C. ECG
• D. MRI

Answer 1

The Correct Option is B

In the context of the given scenario, the patient exhibits symptoms such as seizures, tremors, confusion, and weakness. These symptoms can be side effects or manifestations of lithium toxicity. Since the patient has been on lithium for bipolar disorder and has been fasting, it is crucial to check the lithium levels in her blood. Fasting can affect drug levels due to changes in hydration and electrolytes, potentially leading to accumulation and toxicity.

To accurately diagnose her condition, the most relevant investigation is the measurement of serum lithium levels. Checking serum lithium will help determine if the levels are within the therapeutic range or if they have become toxic due to her recent fasting behavior.

Other investigations like serum electrolytes, ECG, or MRI may provide additional information about the patient’s overall health or concurrent conditions but are not centered on directly diagnosing lithium toxicity. Hence, the primary test necessary to confirm lithium toxicity in this case is serum lithium measurement.