A Patient Presents With Overdose of Ferrous sulfate..

A 32-yr -old man presents to A&E following a deliberate overdose of an unknown quantity of ferrous sulphate. Which of the following statements is true concerning the symptoms and management of this Patient?

A. Early GI features of toxicity are due to systemic iron concentrations
B. Dissolved tablets are radio-opaque before absorption
C. Initial hyperglycaemia indicates significant ingestion
D. Serum iron concentrations of 100 μmol/l are usually asymptomatic
E. Activated charcoal is useful in early presenting Pts

Answer:
C--Initial hyperglycaemia indicates significant ingestion

Discussion: Undissolved iron tablets are radio-opaque. Early features are due to the direct corrosive effects of iron and include vomiting, diarrhea and GI bleeding. Typically, there is then a latent phase of up to 24 hours when the patient is asymptomatic, which is then followed by widespread organ failure. In aptients who recover, there may be long-term strictures due to the initial corrosive effects of iron. Activated charcoal will not adsorb iron since it is a metal. Patients with serum iron concentrations over 90 μmol/l, as well as those with signs of severe toxicity, require chelation therapy with desferrioxamine.

Initial hyperglycaemia can occur in significant ingestions, but hypoglycaemia can be seen in cases of severe poisoning with associated hepatic failure.