An 18-year-old man who had been found unresponsive and face down in his bed after spending the day working in his garage is brought to the hospital emergency department.He had not responded to naloxone administration given by the paramedics.His history reveals that he was despondent over the recent death of his father,with whom he enjoyed restoring antique automobiles.Laboratory results indicate negative serum acetone,elevated serum urea and creatinine,normal PO₂,decreased bicarbonate,increased PCO₂,and increased osmol gap (corrected for ethanol)and anion gap.Urinalysis indicated many oxalate crystals.Based on these laboratory results,what is the likely compound that has affected this individual?

Question

Quizplus · Accepted Answer

The laboratory results suggest ethylene glycol poisoning. Elevated serum urea and creatinine suggest renal failure due to deposition of calcium oxalate crystals in the kidneys, which is a characteristic finding in ethylene glycol poisoning. The normal acetone level rules out alcoholic ketoacidosis as a cause of metabolic acidosis. The increased osmol gap (corrected for ethanol) and anion gap suggest the presence of an unmeasured anion such as glycolic acid, which is produced during the metabolism of ethylene glycol. The presence of oxalate crystals in the urine is also indicative of ethylene glycol poisoning.

An 18-Year-Old Man Who Had Been Found Unresponsive and Face