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Iron overdose — SCE Acute Medicine MCQ

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ModerateToxicology and OverdoseIron overdoseSCE Acute Medicine

A 3-year-old girl is assessed on the acute medical unit. She has abdominal pain and vomiting after ingesting her mother's iron tablets. The time of ingestion is thought to be 2 hours ago. Initial assessment includes relevant observations, bedside tests and urgent blood results. What is the most appropriate investigation?

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Correct answer: D — Serum iron concentration at 4 hours after ingestion

Serum iron concentration at 4 hours after ingestion is the best answer because serum iron concentration at the appropriate post-ingestion time guides chelation decisions. Non-contrast CT head is plausible, but it is less appropriate for the physiology or timing described in this stem. The other distractors either fit a neighbouring presentation, delay definitive treatment, or miss the key immediate risk. Clinical pearl: Early gastrointestinal symptoms can precede shock and hepatic injury.

Reference: Toxbase; BNF