A 23-year-old woman presents 24 hours after acetaminophen overdose with nausea, right upper quadrant pain, and jaundice. Vital signs: BP 110/68, HR 102, RR 16, Temp 37.2°C, SpO2 98%. Laboratory studies show AST 3,200 IU/L, ALT 2,800 IU/L, and INR 1.1. She denies abdominal trauma or recent viral illness. Which mechanism best explains the hepatocellular injury in this patient?
- A)Accumulation of a toxic metabolite that depletes glutathioneGABARITO
- B)Autoimmune destruction of bile ducts
- C)Direct infection of hepatocytes by an RNA virus
- D)Copper accumulation in hepatocytes and basal ganglia
- E)Iron deposition due to increased intestinal absorption
Explicação
Acetaminophen overdose produces excess NAPQI, a toxic metabolite normally detoxified by glutathione. When glutathione stores are depleted, NAPQI causes centrilobular hepatic necrosis; N-acetylcysteine works by replenishing glutathione. Ver explicação completa e trilha adaptativa →