Mood stabilisers: lithium toxicity: practice question

A Psychiatry 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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Psychiatry · Mood stabilisers: lithium toxicity

Sample item

A patient on lithium develops vomiting, diarrhoea, coarse tremor, ataxia and slurred speech. Serum lithium is 2.3 mmol/L. The treatment of choice in severe toxicity is:

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

The answer and the reasoning

A. Haemodialysis

Coarse tremor, ataxia and gastrointestinal upset signal lithium toxicity, which can progress to seizures and coma. Hydration is first, and haemodialysis is indicated for severe toxicity, neurological signs or renal failure; charcoal does not bind lithium.

Option by option

  • A. Haemodialysis (correct)

    Correct. Lithium is small, water-soluble and unbound, so dialysis clears it.

  • B. Activated charcoal alone

    Activated charcoal does not adsorb lithium.

  • C. Haloperidol

    Antipsychotics do not lower levels and may worsen neurotoxicity.

  • D. Forced acid diuresis

    Acid diuresis is not effective for lithium.

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 Psychiatry question

What is the answer to this Psychiatry question?

The best answer is A, Haemodialysis. Coarse tremor, ataxia and gastrointestinal upset signal lithium toxicity, which can progress to seizures and coma.

Why is "Activated charcoal alone" not the answer?

Activated charcoal does not adsorb lithium.

Why is "Haloperidol" not the answer?

Antipsychotics do not lower levels and may worsen neurotoxicity.

Why is "Forced acid diuresis" not the answer?

Acid diuresis is not effective for lithium.

What concept does this question test?

It tests Mood stabilisers: lithium toxicity in Psychiatry. Hydration is first, and haemodialysis is indicated for severe toxicity, neurological signs or renal failure; charcoal does not bind lithium.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Mood stabilisers: lithium toxicity?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry 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.