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Acetaminophen overdose — ABEM Board MCQ

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ModerateToxicologyAcetaminophen overdoseABEM Board

A 19-year-old college student arrives as ESI 2 after taking an unknown number of acetaminophen tablets 6 hours ago. She has nausea but normal mental status. AST is normal and acetaminophen level is above the treatment line on the Rumack-Matthew nomogram. Which of the following is the most important immediate intervention?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Start N-acetylcysteine therapy

N-acetylcysteine is the key time-sensitive intervention when a timed acetaminophen concentration plots above the treatment nomogram line.

Reference: ACMT position statements; Goldfrank Toxicologic Emergencies