Paper II
2023 January (Supplementary) (2019 Scheme) · 100 marks · 180 min

Question

Management of Iron poisoning.

Q114 marksShort Answers

Answer

  • Gastric decontamination — gastric lavage/whole bowel irrigation if presentation is early and ingestion was substantial (activated charcoal is not useful, since it does not bind iron).
  • Supportive care — IV fluids for hypotension/shock, correction of acidosis, monitoring for GI hemorrhage and hepatotoxicity (iron is directly corrosive to the GI mucosa and hepatotoxic in overdose).
  • Deferoxamine — an iron chelator, given IV/IM in significant poisoning; forms a stable, water-soluble complex with free iron, promoting its excretion (classically imparting a “vin rosé” color to the urine).
  • Serum iron levels and clinical severity guide the decision to chelate and monitor response to therapy.

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