Facharzt FMH Kinder- Und Jugendmedizin Practice Questions - Facharzt FMH Für Kinder- Und Jugendmedizin Spécialiste FMH En Pédiatrie Exam

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A 15-year-old adolescent presents 5 hours after an acute intentional ingestion of 16 grams of paracetamol (acetaminophen). The patient is currently asymptomatic with normal physical examination findings. A 4-hour post-ingestion serum paracetamol level returns at 220 mg/L (1450 µmol/L), which plots above the treatment threshold on the Rumack-Matthew nomogram. What is the most appropriate management?

Discharge home with psychiatric follow-up after an observation period of 6 hours Initiate intravenous N-acetylcysteine (NAC) therapy immediately according to standardized dosing protocols Administer oral activated charcoal alone and repeat liver function tests in 24 hours Perform emergency hemodialysis to clear unconjugated paracetamol metabolites

Correct Answer:

Initiate intravenous N-acetylcysteine (NAC) therapy immediately according to standardized dosing protocols

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