Toxicology: isopropyl alcohol: 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: isopropyl alcohol

Sample item

A man is brought in drowsy and ataxic, with acetone-smelling breath and a gastritis picture. Blood glucose is normal, urine ketones are strongly positive, and there is no metabolic acidosis and a normal anion gap. Which alcohol did he most likely drink?

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

The answer and the reasoning

B. Isopropyl alcohol

Isopropyl alcohol is converted to acetone, which causes ketosis without acidosis. It also causes CNS depression and haemorrhagic gastritis. Methanol and ethylene glycol give a high anion gap metabolic acidosis from their toxic acid metabolites.

Option by option

  • A. Methanol

    Methanol gives a high anion gap acidosis and visual symptoms from formic acid.

  • B. Isopropyl alcohol (correct)

    Correct. Ketosis with a normal anion gap and no acidosis points to isopropyl alcohol.

  • C. Ethanol

    Ethanol alone does not explain strong ketonuria with acetone breath, and alcoholic ketoacidosis would show an acidosis.

  • D. Ethylene glycol

    Ethylene glycol gives a high anion gap acidosis and calcium oxalate crystals in urine.

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, Isopropyl alcohol. Isopropyl alcohol is converted to acetone, which causes ketosis without acidosis.

Why is "Methanol" not the answer?

Methanol gives a high anion gap acidosis and visual symptoms from formic acid.

Why is "Ethanol" not the answer?

Ethanol alone does not explain strong ketonuria with acetone breath, and alcoholic ketoacidosis would show an acidosis.

Why is "Ethylene glycol" not the answer?

Ethylene glycol gives a high anion gap acidosis and calcium oxalate crystals in urine.

What concept does this question test?

It tests Toxicology: isopropyl alcohol in Forensic Medicine. It also causes CNS depression and haemorrhagic gastritis. Methanol and ethylene glycol give a high anion gap metabolic acidosis from their toxic acid metabolites.

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: isopropyl alcohol?

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.