MRCP-0764

MRCP-0764

A 25-year-old male presented to accident and emergency 4 days ago, following an intentional paracetamol overdose. He had taken 20x 500mg tablets, all at once. He denies any alcohol intake. Blood investigations 4 hours after ingestion showed: Paracetamol: 14 mg/l INR: 1 Liver enzymes: No abnormality detected Bilirubin: Mild elevation He was seen by the mental health team and discharged. The blood investigations were repeated: Bilirubin: Within normal limits Urea: 21 mmol/L, Creatinine: 300 µmol/L, What is the likely cause of these results?