Acetaminophen (Paracetamol) toxicity Quiz: Ace Your Exams
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A 29-year-old woman arrives at the emergency department with malaise, nausea, and abdominal discomfort. She took several acetaminophen tablets over the past week to manage menstrual pain but is unsure of the exact amount or timing. Her past medical history is significant for dysmenorrhea and migraine headaches. She takes no regular medications and does not smoke or drink alcohol. Temperature is 36.2°C (97.2°F), blood pressure is 125/80 mm Hg, pulse is 76/min, respiratory rate is 16/min, and oxygen saturation is 98% on room air. Physical examination reveals a well-appearing woman with mild tenderness in the right upper abdominal quadrant. Laboratory evaluation is shown below. Which of the following is the best next step in management?
| Test | Result |
| Hemoglobin | 11.4 g/dL |
| Leukocyte count | 11,000/mm3 |
| Platelet count | 300,000/mm3 |
| Sodium | 142 mEq/L |
| Potassium | 4.3 mEq/L |
| Chloride | 101 mEq/L |
| Bicarbonate | 24 mEq/L |
| BUN | 15 mg/dL |
| Creatinine | 0.9 mg/dL |
| AST | 750 U/L |
| ALT | 650 U/L |
| PT | 12 seconds |
| INR | 1.0 |
| Acetaminophen level | Undetectable |
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