Monday, March 7, 2016

In the typical patient who is poisoned by iron::DrSudeepKC

In the typical patient who is poisoned by iron:

iron tonic

a. Hypoglycemia initially occurs then hyperglycemia secondary to pancreatitis.
b. Gastrointestinal hemorrhage is commonly seen secondary to liver dysfunction and coagulation abnormalities.
c. Lactic acidosis is rarely seen in the toxic patient.
d. Strictures may develop late in poisoning causing gastric outlet obstruction or bowel obstruction.
e. The iron accumulates in the bone and may cause pathologic fractures.

The answer is d. Direct caustic effects on the bowel by iron can result in early gastric and small bowel hemorrhage, which can result in hypovolemia and shock.

Late strictures may present as gastric outlet or bowel obstruction. As toxic amounts of iron enter the mitochondria and disrupt oxidative phosphorylation, lactic acidosis occurs.

Hyperglycemia is often seen early, but later hepatic failure results in hypoglycemia. Iron does not accumulate in the bone.


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