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Achilles tendon rupture — RCPSC EM MCQ

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HardMusculoskeletalAchilles tendon ruptureRCPSC EM

A 20-kg child ingests thirty 300-mg ferrous-sulfate tablets. Ferrous sulfate is 20% elemental iron. Which action is most appropriate?

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Correct answer: B — Seek toxicology advice for serum iron, metabolic and hepatic testing

The best answer is “Seek toxicology advice for serum iron, metabolic and hepatic testing”. The estimated elemental iron dose is 30 × 300 mg × 0.20 ÷ 20 kg = 90 mg/kg, well above the level at which systemic toxicity can occur. Obtain early toxicology advice and timed serum iron with metabolic and hepatic assessment; a normal radiograph does not exclude significant ingestion. Early improvement can precede shock or liver failure, so reassurance or delayed assessment is unsafe.

Reference: Emergency Care BC: Iron Overdose: https://emergencycarebc.ca/clinical_resource/clinical-summary/iron-overdose/