Lithium: adverse effects: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pharmacology · Lithium: adverse effects

Sample item

A woman on lithium for bipolar disorder for eight years has coarse tremor, polyuria and an elevated TSH. Which combination of lithium effects is typical?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Tremor, nephrogenic diabetes insipidus and hypothyroidism

Lithium causes tremor, polyuria from nephrogenic diabetes insipidus, hypothyroidism with goitre, weight gain, and hyperparathyroidism with hypercalcaemia on occasion. It has a narrow therapeutic index with the target level of 0.6 to 1.0 mmol/L.

Option by option

  • A. Hyperthyroidism and urinary retention

    Hypothyroidism, not hyperthyroidism, is typical.

  • B. Tremor, nephrogenic diabetes insipidus and hypothyroidism (correct)

    Correct. This is the classic triad of effects.

  • C. Hypertension and bradycardia

    Hypertension and bradycardia are not typical.

  • D. Hypercalcaemia only

    Hypercalcaemia can occur but is not the only effect.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is B, Tremor, nephrogenic diabetes insipidus and hypothyroidism. Lithium causes tremor, polyuria from nephrogenic diabetes insipidus, hypothyroidism with goitre, weight gain, and hyperparathyroidism with hypercalcaemia on occasion.

Why is "Hyperthyroidism and urinary retention" not the answer?

Hypothyroidism, not hyperthyroidism, is typical.

Why is "Hypertension and bradycardia" not the answer?

Hypertension and bradycardia are not typical.

Why is "Hypercalcaemia only" not the answer?

Hypercalcaemia can occur but is not the only effect.

What concept does this question test?

It tests Lithium: adverse effects in Pharmacology. It has a narrow therapeutic index with the target level of 0.6 to 1.0 mmol/L.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Lithium: adverse effects?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.