intoxication q

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intoxication q

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robin082006
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06/10/07 - 11:36 AM

A 45-year-old disheveled man is brought to the emergency department by paramedics stating, “I can't see!” The paramedics tell you that he is a homeless man who was found this morning locked in an automotive garage when the manager of the garage went to open for business. They also state that he was found next to an empty bottle of window washing fluid and an empty 40oz beer can. The patient is alert, but uncooperative during questioning and keeps repeating “Doctor... I just can't see!” As you are examining him, he begins to retch, holds his abdomen and vomits twice. His temperature is 37 C (98.6 F), blood pressure is 150/92 mm Hg, pulse is 100/min, respirations are 24/min, and oxygen saturation is 97% on room air. His pupils are dilated at 5mm and are only sluggishly reactive. Funduscopic examination reveals hyperemia of both discs without papilledema; the cranial nerves are otherwise intact. The remainder of the physical examination is unremarkable except you notice that he is taking very deep and rapid breaths. The most appropriate first diagnostic step is to

A. administer intravenous ethanol and monitor for reversal of his visual deficit

B. observe him in the emergency department as this man is obviously intoxicated with alcohol and just needs to sleep it off

C. order arterial blood gas and serum electrolytes and osmolality

D. perform a CT scan of his head to rule out intracranial pathology

E. request an immediate ophthalmology consult

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prathapdoctor
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06/10/07 - 03:13 PM

Methanol poisoning

?C.

khorshid
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06/10/07 - 06:58 PM

DrVirgo
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06/10/07 - 07:11 PM

methanol poisoning. A.

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Justice
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06/11/07 - 06:07 AM

A

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doyoudig
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06/11/07 - 06:42 AM

should we Diagnose this 1st before Treatment??

Justice
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06/11/07 - 08:22 AM

doyoudig wrote:
should we Diagnose this 1st before Treatment??

Well, (B) is the only diagnostic option here, and it is suitable for ethylen glycol (antifreeze) poisonings... History suggests methanol poisoning. But you are right, something "artificial" is in this Q...

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Aashi
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06/11/07 - 09:02 AM

C--------> order arterial blood gas and serum electrolytes and osmolality

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robin082006
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06/11/07 - 10:37 AM

doyoudig wrote:
should we Diagnose this 1st before Treatment??

Yes.

This is Methanol Intoxication, we should confirm firstly before treatment.

Answer is C

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DrVirgo
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06/11/07 - 04:50 PM

#10

what about quick intervention to prevent blindness?

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