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Ethylene glycol poisoning — RCPSC EM MCQ

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HardToxicologyEthylene glycol poisoningRCPSC EM

CTAS 2: A 46-year-old is confused after drinking garage fluid. Vitals are BP 118/74, HR 112, RR 28. Labs show pH 7.12, HCO3 8, anion gap 28, osmolar gap 34 and creatinine 210 µmol/L. Urine microscopy shows envelope-shaped crystals. What is the most likely diagnosis?

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Correct answer: B — Ethylene glycol poisoning

High anion-gap metabolic acidosis with osmolar gap, renal injury and calcium oxalate crystals indicates ethylene glycol poisoning. Fomepizole and dialysis consultation are required.

Reference: Canadian Poison Centre resources; toxic alcohol guidance