This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Toxicology, Subject name: Forensic Medicine
[{'content': 'Treatment of paracetamol toxicity is \nSelect and explain. \nA. Alkaline diuresis, B. Hemoperfiision, C. Dialysis, D. N - acetyl cysteine', 'role': 'user'}, {'content': "Answer: D \nExplanation: Ans. is 'd' i.e., N - acetyl cysteine Paracetamol poisoning* It is a potent hepatic toxin. A small part is converted by a liver enzyme into N - acetyl-p-benzoquinoneimine.* Glutathione and other sulphydryl compounds detoxify this substance, but in overdose NABP accumulates and causes severe centrilobular liver necrosis.* Large doses act on brain stem and cause rapid death.Symptoms:* Within a few hours - anorexia, nausea, vomiting, abdominal pain, diaphoresis, hypotension, tachycardia and dyspnoea.* After one to two days, the discomfort disappears.* After 2 to 4 days there is vomiting, jaundice, hepatic pain, bleeding, hypoglycaemia, confusion, coma, metabolic acidosis and coarse flapping tremor of hands (asterixis).* There may be cardiac arrhythmias, haemorrhagic pancreatitis, disseminated intravascular coagulation, etc.* Death usually occurs in 3 to 4 days.Treatment:i) Gastric lavage.ii) Activated charcoal.iii) N-acetylcysteine (NAC) is a specific antidote and has maximum efficacy if used within 8 hours.", 'role': 'assistant'}]