Ventricular arrhythmias Quiz: Ace Your Exams
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A 41-year-old female is brought to the emergency department after exhibiting disorganized behavior and vomiting. Per EMS, the patient was yelling and smoking marijuana on the street, after which she began vomiting large amounts of non-bilious non-bloody emesis. She was given several doses of ondansetron and haloperidol prior to arrival, which improved the symptoms. Past medical history is notable for cyclic vomiting syndrome, schizophrenia, and hypothyroidism for which she takes metoclopramide, risperidone, and levothyroxine, respectively. The patient smokes one pack of cigarettes daily and uses marijuana several times per week. Temperature is 37.0°C (98.6°F), pulse is 105/min, respirations are 18/min, and blood pressure is 137/82 mmHg. Physical examination reveals a disheveled woman who is sleeping comfortably in bed. While the nurses are attempting to place an IV, telemetry displays the following finding:

Image reproduced from Wikimedia Commons
Which of the following is the most likely precipitant of this patient’s telemetry finding?

Image reproduced from Wikimedia Commons
Which of the following is the most likely precipitant of this patient’s telemetry finding?
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