Toxicology: ethylene glycol: practice question

A Forensic 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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Forensic Medicine · Toxicology: ethylene glycol

Sample item

A man found drunk-like after drinking antifreeze has an anion gap metabolic acidosis, rising creatinine and envelope-shaped crystals in urine. What is the most appropriate antidote?

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 glycolic and oxalic acids, causing acidosis and calcium oxalate crystals that injure the kidney. Fomepizole inhibits alcohol dehydrogenase and prevents toxic metabolite formation, and haemodialysis is added in severe cases. Ethanol can be used if fomepizole is unavailable.

Option by option

  • A. Hydroxocobalamin

    Hydroxocobalamin treats cyanide poisoning.

  • B. Fomepizole (correct)

    Correct. Fomepizole blocks alcohol dehydrogenase.

  • C. Methylene blue

    Methylene blue treats methaemoglobinaemia.

  • D. Naloxone

    Naloxone reverses opioid toxicity only.

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.

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Questions about this Forensic Medicine question

What is the answer to this Forensic Medicine question?

The best answer is B, Fomepizole. Ethylene glycol is metabolised by alcohol dehydrogenase to glycolic and oxalic acids, causing acidosis and calcium oxalate crystals that injure the kidney.

Why is "Hydroxocobalamin" not the answer?

Hydroxocobalamin treats cyanide poisoning.

Why is "Methylene blue" not the answer?

Methylene blue treats methaemoglobinaemia.

Why is "Naloxone" not the answer?

Naloxone reverses opioid toxicity only.

What concept does this question test?

It tests Toxicology: ethylene glycol in Forensic Medicine. Fomepizole inhibits alcohol dehydrogenase and prevents toxic metabolite formation, and haemodialysis is added in severe cases. Ethanol can be used if fomepizole is unavailable.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Toxicology: ethylene glycol?

Learn postmortem changes with their timelines, and toxicology as poison, sign, test and antidote. Then use the flashcards and the other Forensic 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.