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Forensic Medicine · Toxicology: theophylline toxicity
Sample itemA man with asthma on a sustained-release theophylline preparation takes a double dose by mistake and has vomiting, tremor, sinus tachycardia and a generalised seizure. Which electrolyte abnormality is typical of this toxicity?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
C. Hypokalaemia
Theophylline stimulates beta-2 adrenergic activity and drives potassium into cells, so serum potassium falls. Tachyarrhythmias and seizures are the main life-threatening features, and charcoal and haemodialysis or haemoperfusion are used in severe cases. Hyperkalaemia is not a feature.
Option by option
A. Hypernatraemia
Hypernatraemia is not characteristic of theophylline toxicity.
B. Hyperkalaemia
Hyperkalaemia is seen in digoxin toxicity but not theophylline.
C. Hypokalaemia (correct)
Correct. Intracellular shift of potassium causes hypokalaemia.
D. Hypocalcaemia
Hypocalcaemia is not the characteristic disturbance of theophylline.
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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