UKMLA PLAB AMC USMLE Prometric MCQ

Question Number 0634

Question:
A lady on multiple medications has a recent history of tinnitus. Investigations were all normal and she is discharged from the outpatient clinic. Two weeks later she develops nausea, vomiting, and abdominal pain and is admitted to the Casualty department in acute confusion. On examination she is found to be tacchypneic and febrile and has diffuse bruising. Investigations reveal a mixed metabolic acidosis and respiratory alkalosis. What would the next investigation of choice be?

a) anti-mitochondrial antibodies
b) urinary magnesium levels
c) salicylate levels
d) paracetomol levels
e) look for lytic lesions on plain radiographs