Toxicology: iron poisoning: practice question

A Forensic Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Forensic Medicine · Toxicology: iron poisoning

Sample item

A 2-year-old swallowed many iron tablets and now has haematemesis, shock and radio-opaque tablets on an abdominal X-ray. Which antidote is indicated?

APenicillamineBDeferoxamineCDimercaprolDPrussian blue

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Deferoxamine

Iron overdose causes gastrointestinal bleeding, shock and later hepatic injury and gastric scarring. Deferoxamine binds ferric iron and is given intravenously in symptomatic patients or those with a high serum iron, producing vin rose coloured urine. Iron tablets are radio-opaque, so an abdominal film helps assess the load.

Option by option

A. Penicillamine
Penicillamine is used for copper in Wilson disease and is not the antidote for acute iron poisoning.
B. Deferoxamine (correct)
Correct. Deferoxamine chelates iron.
C. Dimercaprol
Dimercaprol is used for arsenic, mercury and lead and is not recommended for iron.
D. Prussian blue
Prussian blue is used for thallium.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Forensic Medicine question

What is the answer to this Forensic Medicine question?

The best answer is B, Deferoxamine. Iron overdose causes gastrointestinal bleeding, shock and later hepatic injury and gastric scarring.

Why is "Penicillamine" not the answer?

Penicillamine is used for copper in Wilson disease and is not the antidote for acute iron poisoning.

Why is "Dimercaprol" not the answer?

Dimercaprol is used for arsenic, mercury and lead and is not recommended for iron.

Why is "Prussian blue" not the answer?

Prussian blue is used for thallium.

What concept does this question test?

It tests Toxicology: iron poisoning in Forensic Medicine. Deferoxamine binds ferric iron and is given intravenously in symptomatic patients or those with a high serum iron, producing vin rose coloured urine. Iron tablets are radio-opaque, so an abdominal film helps assess the load.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Toxicology: iron poisoning?

Learn postmortem changes with their timelines, and toxicology as poison, sign, test and antidote. Then use the flashcards and the other Forensic Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.