<prompt> A patient was on lithium therapy for bipolar disorder for 6 months. She kept fast for few days due to religious reasons and presented with coarse tremors, abdmoninal pain, nausea, dizziness confusion. Which of the following should be done to assess her condition?S. electrolyteS. lithium levelsECGMRI  <response>: This is a case of lithium toxicity so next best management is to measure lithium levels. Signs of Lithium toxicity Dehydration, low sodium diet, renal impairment- precipitates lithium toxicity Narrow TI 1.5 mEqdL GI symptoms-Abdominal pain, vomiting CNS : Coarse tremors, ataxia, dysahria Muscle fasciculations, increased DTR, convulsions, impaired consciousness, death Management: Stop LITHIUM Correct dehydration Use of sodium polystyrene sulfonate or polyethylene glycol to remove unabsorbed lithium from GI Hemodialysis in severe cases 