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Methanol poisoning — RCPSC EM MCQ

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ModerateToxicologyMethanol poisoningRCPSC EM

A 37-year-old man presents after drinking windshield-washer fluid. He is confused, respiratory rate is 30/min and vision is blurred. ABG shows pH 7.08, bicarbonate 7 mmol/L, osmolar gap is elevated and anion gap is 31. What is the most likely diagnosis?

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Correct answer: D — Methanol poisoning

Visual symptoms plus high anion-gap metabolic acidosis and elevated osmolar gap after washer-fluid ingestion indicate methanol poisoning. Fomepizole, bicarbonate and haemodialysis assessment are urgent.

Reference: Canadian poison centre guidance; Goldfrank's Toxicologic Emergencies