CARDIOLOGY
EISENMENGER S SYNDROME
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Question
[CLICK ON ANY CHOICE TO KNOW THE RIGHT ANSWER]
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A 3-year-old boy is brought to the emergency department 30 minutes after ingesting one of his grandmother’s medications. The boy’s mother reports that the grandmother takes medications for depression and hypertension. During the first hour of being monitored in the ED, the boy becomes increasingly lethargic and develops mydriasis and a dry mouth. You notice on the cardiopulmonary monitor that his heart rate is 130 beats/min and he now appears to have a prolonged QRS duration. An electrocardiogram demonstrates a QRS duration of 110 milliseconds, right axis deviation, and prolonged PR and QT intervals MOST likely medication ingested by the patient is
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amitriptyline
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clonidine
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fluoxetine
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labetalol
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nicardipine
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Explanation:
Detailed explanation-1: -Administration of sodium bicarbonate might be beneficial for patients with severe or life-threatening TCA toxicity if a prehospital protocol exists for its use (Grades B/D).
Detailed explanation-2: -Administration of intravenous sodium bicarbonate as an antidote has been shown to be an effective treatment for resolving the metabolic acidosis and cardiovascular complications of TCA poisoning.
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