A 4-year-old who swallowed multiple prenatal iron tablets is brought vomiting with hematemesis. Which chelating agent is the specific antidote, and what bedside finding supports adequate therapy?

• A Dimercaprol, with resolution of gingival Burton's line
• B Deferoxamine, with vin rose coloured urine ✓
• C Penicillamine, with disappearance of Kayser-Fleischer ring
• D Calcium disodium EDTA, with clearing of basophilic stippling

Explanation

Acute iron poisoning is treated with deferoxamine, which chelates ferric iron and is excreted renally as ferrioxamine, giving the urine a characteristic vin rose or port-wine colour when significant iron is being cleared. Dimercaprol is used for arsenic and mercury, penicillamine for copper, and calcium disodium EDTA for lead, so each distractor pairs a real chelator with the wrong metal and the wrong monitoring sign.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.