Case challenge · Emergency / Toxicology / Critical care · teaching

Methanol / Ethylene Glycol Poisoning — Management Pathway · case challenge

Given a case, work through the care pathway step by step; the tool checks each choice and scores you. Decisions and basis are taken from this site's reviewed care pathways.

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Case #1Emergency / Toxicology / Critical care

📋 Case data

Start the antidote?Confirmed/highly suspected (raised osmolar gap or unexplained high-AG acidosis)

Data is taken from this pathway's reviewed node text. Work through the pathway step by step.

Step 1 / 1 · Start the antidote?

High-anion-gap acidosis + suspected toxic-alcohol ingestion — start the antidote?

💡 Methanol (windshield fluid/industrial solvent/counterfeit liquor) and ethylene glycol (antifreeze, sweet) are metabolized by alcohol dehydrogenase (ADH) into toxic acids — methanol → formic acid (visual injury/blindness), ethylene glycol → oxalate (AKI/hypocalcemia). Diagnosis: high-anion-gap acidosis + raised osmolar gap (a normal osmolar gap does not exclude it and falls as metabolism proceeds; serial anion gap q2–4 h is sensitive); calcium oxalate crystalluria (ethylene glycol); confirm with drug levels.

For teaching. Decisions and their basis are taken from this site's reviewed care pathways; for licensed clinicians/trainees, this does not replace clinical judgment or local protocols.