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Iron overdose — MCCQE Part 1 MCQ

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HardPoisoning/OverdoseIron overdoseMCCQE Part 1

2-year-old child presents with vomiting after ingesting prenatal vitamins. Abdominal radiograph shows tablets and serum iron is high. Which of the following is the most appropriate next step?

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Correct answer: D — Consult poison centre and give deferoxamine if severe according to level/symptoms

Consult poison centre and give deferoxamine if severe according to level/symptoms is best because iron overdose can cause severe metabolic toxicity in children. Wait for confirmatory testing before any stabilisation is suboptimal because resuscitation and time-critical treatment should not wait when instability is present; Discharge once symptoms temporarily improve is suboptimal because temporary improvement can precede deterioration; Give an adjunctive medication as the sole first-line treatment is suboptimal because adjuncts do not replace definitive stabilisation; Delay escalation until cardiac arrest or respiratory failure occurs is suboptimal because early escalation is central to emergency care. A symptom-free interval can precede shock and hepatic injury.

Reference: Canadian poison centre guidance