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Paracetamol Overdose Quiz - Statistics
General Stats
- This quiz has been taken 6 times
- The average score is 17 of 48
Answer Stats
| Hint | Answer | % Correct |
|---|---|---|
| 1.3 | 80%
| |
| A paracetamol overdose is often asymptomatic in the early stages. How many hours can it typically take for symptoms to develop? | 24-72 hours | 80%
|
| A life-threatening paracetamol overdose with a poor prognosis can have the following features: an INR greater than ___, | 3 | 80%
|
| If the patient presents 1-8 hours after ingestion, how long must the doctor wait FROM THE TIME OF INGESTION to assess the paracetamol level? | 4 hours | 60%
|
| If a patient presents with a STAGGERED paracetamol overdose, is NAC started immediately? | Yes | 60%
|
| What is the treatment threshold for a paracetamol overdose, i.e. the amount of paracetamol that must have been consumed to necessitate medical intervention? (NB: answer is given as mg per kg of patient's body weight.) | 150mg/kg | 40%
|
| ...a plasma creatinine greater than ___ micromol/L, | 200 | 40%
|
| ...and a blood pH less than ___. | 7.3 | 40%
|
| "If a paracetamol level will not be available within ______ of ingestion, NAC is started immediately." | 8 hours | 40%
|
| Abdominal/RUQ pain | 40%
| |
| If the patient presents within ONE hour of ingestion, they are treated with...? | Activated charcoal | 40%
|
| If a patient presents >24 hours after ingestion, they are given NAC if their ____ is raised, or INR is greater than _____. | ALT | 40%
|
| In what circumstance can NAC be administered, even if the patient does not meet the treatment threshold? | Evidence of hepatic injury | 40%
|
| What other blood tests will be performed on a patient presenting with paracetamol overdose? | FBC | 40%
|
| Hypotension | 40%
| |
| Jaundice | 40%
| |
| If a patient presents >24 hours after ingestion, they are given NAC IMMEDIATELY if they are j_____ or have hepatic t_______. | jaundiced | 40%
|
| LFTs | 40%
| |
| A patient presents with a paracetamol overdose ten hours after ingestion. Bob says a paracetamol level should be taken, and they should wait 4 hours to assess if NAC is necessary. Linda says they should take the level and give NAC immediately. Who is correct? | Linda. The patient has presented >8 hours after ingestion, so NAC is given immediately. | 40%
|
| Does a paracetamol overdose raise or lower blood pH? | Lower | 40%
|
| What does NAC stand for? | N-acetyl cysteine | 40%
|
| NAPQI | 40%
| |
| List the symptoms of a paracetamol overdose | Nausea | 40%
|
| What is the name of the graph which is used to determine the patient's need for NAC? | Nomogram | 40%
|
| A patient presents with a staggered overdose. Fred says they don't need to take a paracetamol level, because the overdose is staggered. Jen says they take a paracetamol level if the patient has symptoms. Oli says they take a paracetamol level 4 hours after the last ingestion of paracetamol. Anna says they take a paracetamol level upon admission. Who is right? | Oli | 40%
|
| Where does this process mainly occur? | The liver | 40%
|
| "If a patient with a paracetamol overdose presents to A&E two hours after ingestion, doctors will not administer treatment for another two hours, so that paracetamol levels can be assessed to determine the need for treatment." True or false? | True | 40%
|
| U&E | 40%
| |
| Vomiting | 40%
| |
| Anorexia | 20%
| |
| Asterixis (flapping hand tremour) | 20%
| |
| Coma | 20%
| |
| Confusion / altered mental status | 20%
| |
| CYP | 20%
| |
| Encephalopathy | 20%
| |
| What is the most common metabolic pathway for paracetamol? | Glucuronidation | 20%
|
| This toxic intermediate is detoxified by _____? | Glutathione (GSH) | 20%
|
| The final metabolic pathway for paracetamol is n-_______ and dehydration/rearrangement. This process is ____ mediated. This pathway creates a toxic intermediate called _____. | hydroxylation | 20%
|
| If the patient has hepatic necrosis, they may also exhibit additional signs: | Hypoglycaemia | 20%
|
| INR | 20%
| |
| Malaise | 20%
| |
| Metabolic acidosis | 20%
| |
| Oliguria/anuria | 20%
| |
| What metabolic pathway processes approximately a third of total paracetamol? | Sulfation | 20%
|
| Tachycardia | 20%
| |
| tenderness | 20%
| |
| Venous blood gas (VBG) | 20%
| |
| What are the clinical signs of a paracetamol overdose? | Bruising | 0%
|
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