Gastroenterology Education and CPD for trainees and specialists

1. Which one of the following statements regarding paracetamol overdose is false?

1. The toxic metabolite in paracetamol overdose is NAPQI
2. Kidney injury occurs by metabolite other than NAPQI
3. Patients getting anticonvulsant like phenytoin is high risk of liver injury from paracetamol overdose
4. Lab results can be normal in D1
5. NAC is the antidote to paracetamol overdose

2. Which one of the following statements regarding paracetamol overdose is false?

1. Metabolic acidosis with pH of <7.3 after fluid resuscitation is an indication for liver transplant
2. The first bag of NAC in treatment of paracetamol overdose contains NAC 100mg/kg.
3. NAC has anti-oxidant property
4. Prognostic accuracy of Rumack-Matthew nomogram decreases after 15hours
5. Paracetamol level is highest after 4 hours after ingestion.

3. Which one of the following statements regarding paracetamol overdose is true?

1. An INR> 4 and a serum creatinine concentration greater than 200 µmol/L in presence of grade III or IV encephalopathy- warrants liver transplantation.
2. An AST of 400 requires referral to transplant unit
3. Patients on primidone are not at any increased risk
4. The prognostic nomogram is not applicable in staggered ingestion
5. NAC cannot be continued if flushing occurs on administration

Gastroenterology training and education

MCQ On Paracetamol overdose

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