QuestionSBA
QuestionChoice
Primary hyperaldosteronism would cause hypokalaemia which could precipitate digoxin toxicity, however the patient would be expected to be hypertensive. This is also not a common diagnosis.
10028417
b
Conn's syndrome
QuestionChoice
This is correct. This scenario describes digoxin toxicity which is known to be precipitated by hypokalaemia. Normally digoxin binds to the ATPase pump at the same site as potassium, therefore hypokalaemia precipitates digoxin toxicity as there is less competition to bind to the ATPase pump and digoxin exerts more of an inhibitory effect. Diarrhoea and vomiting due to a gastroenteritis are likely to account for this clinical picture.
10028416
a
Gastroenteritis
QuestionChoice
Rhabdomyolysis may be associated with severe hyperkalaemia, rather than hypokalaemia.
10028420
e
Rhadbomyolysis
QuestionChoice
Potassium concentration is typically normal in SIADH.
10028419
d
Syndrome of inappropriate ADH
QuestionChoice
Ramipril may cause hyperkalaemia which would protect against developing digoxin toxicity.
10028418
c
Ramipril
QuestionComment
Did they mean to give us the potassium?
43818
QuestionComment
i think they expect us to know that gastroenteritis (vomiting and diarrhoea) would lead to hypokalaemia and then that would lead to digoxin toxicity
44766
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C3rberus
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Acute Intubation
QuestionComment
Where is the information on diarrhoea and vomitng and hypokalaemia??? Am I just blind?? I don't see nothing?
57249
QuestionComment
we're all blind
57782
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Abxxxicimab
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Nightshift Zygomatic
QuestionComment
Is the only clue here the yellow-green tinge?? no mention of D/V or hypokalaemia in the stem or have i gone mad
59390
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Epidermis Cystic
QuestionComment
yellow tinge= digoxin toxicity. Digoxin toxicity is precipitated by hypokalaemia. All options EXCEPT gastroenteritis cause HYPERkalaemia, so wouldn't precipitate digoxin toxicity. Gastroenteritis causes hypokalaemia due to vomiting and diarrhoea 
59919
QuestionComment
apart from conn's )
61697
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Defibrillator Dominant
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Migraine Biopsy
Concept
Chapter
2693
3722
Digoxin
Topic
134
Cardiology
18081
Gastroenteritis can increase the risk of digoxin toxicity because it can lead to dehydration, electrolyte imbalances (such as low potassium or magnesium levels), and reduced kidney function, all of which can enhance the effects of digoxin and increase the likelihood of toxic side effects.
A 69 year old man is brought to the emergency department acutely confused and unable to recall the events of the last few days. He describes a green-yellow tinge to his vision. His current medications include bisoprolol, ramipril and digoxin. His blood pressure has been measured on repeat GP appointments at ~110/60mmHg.

Which of the following is the most likely to explain the patient’s presentation?
a