skip to main content

Ethylene glycol toxicity — ABEM Board MCQ

Instant feedback + full explanation. One question, done properly.

HardToxicologyEthylene glycol toxicityABEM Board

A 39-year-old man arrives confused after drinking antifreeze. Triage acuity is ESI 2; BP 132/78 mm Hg, HR 118/min, RR 28/min. Labs show pH 7.12, anion gap 30, osmolar gap 26, creatinine 2.1 mg/dL, and calcium oxalate crystals in urine. Which of the following is the most appropriate next step in management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Start fomepizole and arrange hemodialysis consultation

Ethylene glycol causes anion-gap acidosis, osmolar gap, renal injury, and oxalate crystals; fomepizole is the antidote, with dialysis for severe toxicity.

Reference: ACMT toxic alcohol guidance