NEET PG / USMLE – MCQ 6

A 21-year-old man is brought to the emergency department by friends because of blurred vision, headache, abdominal pain, nausea, and vomiting for 30 minutes. His friends say that he drank 60 mL of wood alcohol 1 hour ago after a bet at a fraternity house party. His pulse is 58/min and regular, respirations are 28/min and shallow, and blood pressure is 130/72 mm Hg. Physical examination shows no other abnormalities. Laboratory studies show:

Serum
Na+ – 139 mEq/L
Cl− – 85 mEq/L
K+ – 4.5 mEq/L
HCO3− – 13 mEq/L

Urine
pH – 5
Crystals – none

Arterial blood gas analysis on room air:
pH – 7.28
PO2 – 108 mm Hg
PCO2 – 22 mm Hg

Which of the following is the most appropriate initial treatment for this patient?
(A) Intravenous ethanol therapy
(B) Intravenous sodium bicarbonate therapy
(C) Oral acetylcysteine therapy
(D) Oral activated charcoal therapy
(E) Hemodialysis

Correct answer : (A) Intravenous ethanol therapy

Explanation: This is a case of methyl alcohol posioning. Intravenous ethanol is administered to prevent toxicity and complications like blindness.

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