pediatric emergency MCQ-No2

Question 2

•A young male presents to the ED unable to give a history. As part of the work-up, you find an anion gap (AG) of 38. All of the following are possible etiologies of this patient’s problem EXCEPT
A.Lactic acidosis
B.Ethylene glycol
C.Hyperglycemic hyperosmolar state
D.Renal failure
E.Isopropanol

Answer & Comments
•E
•Comments:
–Isopropanol, also known as isopropyl alcohol, is commonly found in rubbing alcohol.
–The clinical features of isopropanol intoxication are similar to those of ethanol intoxication.
–Laboratory studies of patients who have ingested this alcohol show a normal or minimal AG, with an elevated osmolar gap.
–Patients with an AG greater than 35 usually have ethylene glycol or methanol intoxication, hyperglycemic hyperosmolar coma, or lactic acidosis.
–MUDPILES is the mnemonic for the etiologies of an AG
•M for methanol,
•U for uremia,
•D for diabetic ketoacidosis,
•P for paraldehyde,
•I for iron/isoniazid,
•L for lactic acidosis,
•E for ethanol and ethylene glycol,
•S for salycilates