Emergency and critical care: ethylene glycol poisoning: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Emergency and critical care: ethylene glycol poisoning

Sample item

A man is brought after drinking radiator coolant. He is drunk, tachypnoeic, has a pH of 7.1 with a high anion gap and osmolar gap, and urine shows envelope-shaped crystals. Which drug is the antidote of choice?

AFlumazenilBFomepizoleCAtropineDNaloxone

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Fomepizole

Ethylene glycol is metabolised by alcohol dehydrogenase to toxic acids and oxalate, which cause acidosis, calcium oxalate crystals and renal failure. Fomepizole blocks alcohol dehydrogenase, and haemodialysis removes toxin in severe cases.

Option by option

A. Flumazenil
Flumazenil reverses benzodiazepines.
B. Fomepizole (correct)
Correct. Fomepizole blocks the enzyme that makes the toxic metabolites.
C. Atropine
Atropine treats cholinergic toxicity.
D. Naloxone
Naloxone reverses opioids.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is B, Fomepizole. Ethylene glycol is metabolised by alcohol dehydrogenase to toxic acids and oxalate, which cause acidosis, calcium oxalate crystals and renal failure.

Why is "Flumazenil" not the answer?

Flumazenil reverses benzodiazepines.

Why is "Atropine" not the answer?

Atropine treats cholinergic toxicity.

Why is "Naloxone" not the answer?

Naloxone reverses opioids.

What concept does this question test?

It tests Emergency and critical care: ethylene glycol poisoning in General Medicine. Fomepizole blocks alcohol dehydrogenase, and haemodialysis removes toxin in severe cases.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Emergency and critical care: ethylene glycol poisoning?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.