ABEM Medical Tox Practice Questions - ABEM Medical Toxicology Subspecialty Certification Exam

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A patient presents 6 hours after a single acute acetaminophen ingestion with a 4-hour-equivalent serum acetaminophen level of 160 mcg/mL. According to the Rumack-Matthew nomogram, which is correct?

The level is above the 150 mcg/mL treatment line at 4 hours — start N-acetylcysteine The level is below the treatment line — observe without NAC Nomogram is invalid; treat empirically only if LFTs elevated Start hemodialysis immediately

Correct Answer:

The level is above the 150 mcg/mL treatment line at 4 hours — start N-acetylcysteine

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