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Ethylene glycol poisoning — RCPSC EM MCQ

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HardToxicologyEthylene glycol poisoningRCPSC EM

CTAS 1. A 46-year-old is brought from a shelter confused after drinking unknown fluid. pH is 7.12, anion gap is 28, osmolar gap is elevated, creatinine is 210 µmol/L, and urine shows calcium oxalate crystals. What is the most appropriate initial management?

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Correct answer: A — Fomepizole and urgent haemodialysis consultation

Severe high anion gap acidosis with osmolar gap, kidney injury, and oxalate crystals suggests ethylene glycol poisoning requiring alcohol dehydrogenase blockade and dialysis consideration.

Reference: Ontario Poison Centre toxic alcohol guidance; Goldfrank's Toxicologic Emergencies