Neuroimaging: methanol poisoning: practice question

A Radiology 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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Radiology · Neuroimaging: methanol poisoning

Sample item

A man brought in after drinking illicit liquor has visual loss and severe metabolic acidosis. MRI shows bilateral symmetric necrosis of the putamen with haemorrhagic foci. Which toxin is most likely?

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

The answer and the reasoning

C. Methanol

Methanol is converted to formic acid, which poisons the optic nerve and causes necrosis of the putamina, sometimes with haemorrhage, with anion gap acidosis. Ethylene glycol mainly injures the kidneys, isopropyl alcohol causes ketosis without acidosis, and ethanol does not cause putaminal necrosis.

Option by option

  • A. Ethanol

    Ethanol intoxication does not cause putaminal necrosis.

  • B. Isopropyl alcohol

    Isopropyl alcohol causes ketosis and sedation without a severe acidosis.

  • C. Methanol (correct)

    Correct. Visual loss, acidosis and putaminal necrosis indicate methanol.

  • D. Ethylene glycol

    Ethylene glycol causes renal injury with calcium oxalate crystals.

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 Radiology question

What is the answer to this Radiology question?

The best answer is C, Methanol. Methanol is converted to formic acid, which poisons the optic nerve and causes necrosis of the putamina, sometimes with haemorrhage, with anion gap acidosis.

Why is "Ethanol" not the answer?

Ethanol intoxication does not cause putaminal necrosis.

Why is "Isopropyl alcohol" not the answer?

Isopropyl alcohol causes ketosis and sedation without a severe acidosis.

Why is "Ethylene glycol" not the answer?

Ethylene glycol causes renal injury with calcium oxalate crystals.

What concept does this question test?

It tests Neuroimaging: methanol poisoning in Radiology. Ethylene glycol mainly injures the kidneys, isopropyl alcohol causes ketosis without acidosis, and ethanol does not cause putaminal necrosis.

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 Neuroimaging: methanol poisoning?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology 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.