USMLE Step 3 - Question 13

A 46 year old female with a history of alcohol abuse was brought to the emergency room for altered mental status. Her temperature is 37.0 C (98.6 F), blood pressure is 120/80, heart rate 70, respirations 16. Physical examination reveals a cachectic appearing female, normal breath sounds, and normal heart sounds without murmurs. In the emergency room she becomes completely unresponsive for 1 minute and her blood pressure decreases to 50/30. Her telemetry strip during the event is below as well as her 12 lead ECG afterwards.

Torsades

Step2-Q8-PIC1

What is the best treatment at this time?

A. Intravenous saline

B. Intravenous procainamide

C. Intravenous calcium

D. Intravenous magnesium

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