Case 6 - PBL answers

Question 1

where is the most common place for a lesion in MS

Answer 1

cerebral lesions are the most common

Question 2

how does a paracetamol overdose occur

Answer 2

the sulphate and glucoronide pathways become saturated, and more paracetamol is shunted to the cytochrome P450 system to produce NAPQI. as a result, hepatocellular supplies of glutathione become depleted, as the demand for glutathione is higher that its regeneration. NAPQI therefore remains in its toxic form in the liver and reacts with cellular membrane molecules, resulting in widespread hepatocyte damage and death, leading to acute liver necrosis