27-year-old Woman in Medicine / Internal Medicine — 27yo Woman | Gastroenterology | SMLE Q#12044
SMLE Question #12044
Medicine / Internal Medicine
Gastroenterology
Objective: OBJ-433
Last updated: February 2026
A 27-year-old woman presents to the emergency department 4 hours after intentionally ingesting an unknown number of immediate-release paracetamol tablets. She denies other co-ingestions. She is asymptomatic and alert and oriented. A 4-hour serum paracetamol concentration is above the treatment threshold on the Rumack–Matthew nomogram, and baseline liver tests are normal. What is the most appropriate next step in management?
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