Presentation

You are a final year medical student on an Emergency Medicine clinical attachment. 

It has been a long night at the Emergency Department, with the Christmas holidays fast-approaching. You are getting ready to call it a night when an ambulance pulls in. 

Andrew is brought in, accompanied by his mother, who is besides herself. You ask Andrew what has happened. However, his speech is slurry and you cannot make out what he is saying. He also appears lethargic and jaundiced. Purpura and profound ascites are also apparent. 

After an initial assessment, you realize Andrew is very unwell and you need to act quickly. 

You turn to the mother, who explains that Andrew has been battling with his 'condition', she whispers 'schizophrenia'. He has previously attempted suicide, using some headache pills. She is not sure whether he has attempted suicide again. 

You order some blood tests, including paracetamol levels, as you suspect that this is related to toxicity with this drug. 

Which drug should you administer at this point? 

  • Activated charcoal
  • N acetyl cysteine
  • Furosemide and spironolactone
  • Propranolol
  • Terlipressin

Map: Andrew Hall (1102)
Node: 20950
Score:

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