new_n_lost
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A 60 year old patient has recently been commenced on Digoxin. Which of the following features is likely to suggest digoxin toxicity?
A. Vomiting
B. Reverse tick in the lateral leads on ECG
C. Blindness
D. Chest pain
E. Supraventricular ectopics
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| Aashi
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B. Reverse tick in the lateral leads on ECG
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| usmle4me
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B. ECG reverse tick in V5 V6
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| new_n_lost
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Answer: a) vomiting. Digoxin toxicity can cause symptoms of nausea and vomiting, xanthopsia (yellowness in vision), dizziness, bradycardia and lethargy. Reversed tick in the ST segments can be associated with digoxin use and is not necessarily a sign of toxicity.
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| new_n_lost
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Guys i have chked this and was wondering if u agree or not. The Reverse Ticks which r Depressed ST segments on V5-V6 leads do suggest Digioxin use but do not Signify Toxicity.
PVC Premature ventricular contractions are the most common dysrhythmia. Bigeminy or trigeminy occurs frequently.
ST segment changes are pretty characteristic, with their "reverse tick" conformation. These changes are not indicative of toxicity, but merely the presence of digitalis. With toxicity, practically any arrhythmia can be seen, although certain arrhythmias are highly suggestive, for example, the presence of both increased irritability and AV nodal block (such as paroxysmal atrial tachycardia with a 2:1 AV nodal block). <!-- -->
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| usmle4me
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I think B. is sign of toxicity and not normally +nt with Rx
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| usmle4me
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Yes I was wrong here.It can be present in digoxin treatment.And so looking for other signs is important. if it is present in lateral leads it is not a toxicity but if present in all leads it is!!
Sorry for the confussion.
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| new_n_lost
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buddy Atleast u Tried to Answer the Question with some thought trying a question silently n then trying a question openly n then submitting ur answer gives u confidence. N thats wht we all need to build n cultivate.
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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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