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Medicine Toxicology 644a2452

Oxalate crystals in urine is seen in: (PGI Dec 2006)

A
Ethylene glycol poison
B
Di glycol poison
C
Alcohol
D
Indinavir
High-Yield Explanation
Ans: A (Ethylene glycol poisoning) Ethylene Glycol Poisoning# Ingestion of ethylene glycol (commonly used in antifreeze) leads to a metabolic acidosis and severe damage to the central nervous system, heart, lungs, and kidneys. The increased AG and osmolar gap are attributable to ethylene glycol and its metabolites, oxalic acid, glycolic acid, and other organic acids. Lactic acid production increases secondary to inhibition of the tricarboxylic add cycle and altered intracellular redox state.# Diagnosis is facilitated by recognizing oxalate crystals in the urine(r) the presence of an osmolar gap in serum, and a high-AG acidosis. If anti freeze containing a fluorescent dye is ingested, a Wood's lamp applied to the urine may be revealing. Treatment should not be delayed while awaiting measurement of ethylene glycol le%rels in this setting

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