Paracetamol Overdose Quiz

A paracetamol overdose is often asymptomatic in the early stages. How many hours can it typically take for symptoms to develop?

List the symptoms of a paracetamol overdose

 

 

 

 

 

What are the clinical signs of a paracetamol overdose?

 

 

 

 

 

If the patient has hepatic necrosis, they may also exhibit additional signs:

 

 

 

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.)

If the patient presents within ONE hour of ingestion, they are treated with...?

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?

What is the name of the graph which is used to determine the patient's need for NAC?

What does NAC stand for?

"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?

In what circumstance can NAC be administered, even if the patient does not meet the treatment threshold?

"If a paracetamol level will not be available within ______ of ingestion, NAC is started immediately."

What other blood tests will be performed on a patient presenting with paracetamol overdose?

 

 

 

 

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?

If a patient presents >24 hours after ingestion, they are given NAC IMMEDIATELY if they are j_____ or have hepatic t_______.

 

If a patient presents >24 hours after ingestion, they are given NAC if their ____ is raised, or INR is greater than _____.

 

If a patient presents with a STAGGERED paracetamol overdose, is NAC started immediately?

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?

Does a paracetamol overdose raise or lower blood pH?

A life-threatening paracetamol overdose with a poor prognosis can have the following features: an INR greater than ___,

...a plasma creatinine greater than ___ micromol/L,

...and a blood pH less than ___.

What is the most common metabolic pathway for paracetamol?

Where does this process mainly occur?

What metabolic pathway processes approximately a third of total paracetamol?

The final metabolic pathway for paracetamol is n-_______ and dehydration/rearrangement. This process is ____ mediated. This pathway creates a toxic intermediate called _____.

 

 

This toxic intermediate is detoxified by _____?