USMLE Step 1 Question of the Day
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A 65 year old male with a history of heart failure sees his physician for a routine checkup. He has been on a stable regimen of metoprolol and furosemide to manage his blood pressure and heart failure. A routine ECG in the office shows flattening of the T wave, appearance of a U wave, and ST segment depression. What is the most likely explanation for the ECG findings?
Correct Answer: D. Low serum potassium
The ECG findings are characteristic of hypokalemia. This man is at risk of hypokalemia because he is on long-term furosemide.
Isolated magnesium abnormalities (A,C) do not typically cause these ECG abnormalities.
(B) High serum potassium typically manifests as peaked T waves, shortened QT interval, disappearance of p waves, and eventually a widened QRS and a sine wave pattern.
(E) Flattening of the T wave and U waves are not typical of MI.
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Category: PhysiologyA 65 year old male with a history of heart failure sees his physician for a routine checkup. He has been on a stable regimen of metoprolol and furosemide to manage his blood pressure and heart failure. A routine ECG in the office shows flattening of the T wave, appearance of a U wave, and ST segment depression. What is the most likely explanation for the ECG findings?
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