A 17-year-old girl presented with jaundice three days after having taken a paracetamol and alcohol overdose during an argument with her boyfriend

A 17-year-old girl presented with jaundice three days after having taken a paracetamol and alcohol overdose during an argument with her boyfriend.
What is the best marker of prognosis?

a. Serum aspartase transaminase.
b. Serum alkaline phosphatase.
c. Serum bilirubin.
d. Prothrombin time.
e. Paracetamol level.

Answer:

d. Prothrombin time.

Important risk markers for severe hepatic injury after paracetamol overdose include a PT >20 seconds 24 h after ingestion, pH <7.3 and creatinine >300 mol/l. (See Questions 27 and 206.)