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RUSVM Toxicology 2016 > Ethylene Glycol > Flashcards

Ethylene Glycol Flashcards

1
Q

What are the sources of Ethylene glycol?

A

Antifreeze
Coolant
Rust remover
Industrial solvent

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2
Q

Properties of Ethylene glycol?

A 
soluble in water
sweet
colorless
odorless
Lowers the freezing point of water
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3
Q

Where is Ethylene glycol absorbed from?

A

GI tract

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4
Q

What is the half life of Ethylene glycol?

A

3-4 hours

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5
Q

Where is Ethylene glycol mainly metabolized?

A

Liver

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6
Q

Toxicokinetics of Ethylene glycol?

A

Oxalic acid binds to serum calcium to form insoluble calcium oxalate crystals and hypocalcemia

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7
Q

What is the mechanism of action of Ethylene glycol?

A

Direct GI irritation
Increases serum osmolality
CNS depression

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8
Q

What do the toxic metabolites of Ethylene glycol cause?

A

Metabolic acidosis
Acute renal failure
Glycoaldehyde cause CNS dysfunction by inhibition of respiration
Calcium oxalates contribute to CNS damage
Calcium oxalate monohydrate crystals form within the renal tubules

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9
Q

What causes Metabolic acidosis with Ethylene glycol toxicosis?

A

Glycolic acid

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10
Q

What is responsible for Kidney Damage associated with Ethylene glycol?

A

Calcium oxalate monohydrate crystal formation in the renal tubules

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11
Q

What are the early clinical signs of Ethylene glycol toxicosis?

A 
Nausea
vomiting
anorexia
CNS depresison 
ataxia
incoordination 
hypothermia
muscle fasciculations
tachycardia
tachypnea
polyuria
polydipsia
dehydration 
coma
death
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12
Q

What are the late clinical signs of Ethylene glycol toxicosis?

A 
oliguric renal failure
vomiting
anorexia
depression 
severe lethargy 
coma
seizures 
oliguria 
renal pain
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13
Q

What are the gross lesions associated with Ethylene glycol toxicosis?

A

Hemorrhagic gastroenteritis
Pulmonary edema
Pale and swollen kidneys with gray or yellow streaks

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14
Q

What microscopic lesions are associated with Ethylene glycol toxicosis?

A 
Yellow birefringent rosette shaped calcium oxalate monohydrate crystals in the kidney or urine 
Perivascular spaces in the brain
Increased serum osmolality 
Increased anion gap 
Low Urine SpGr
Blood pH less than 7.3
Hyperglycemia 
Hypocalcemia
Increased BUN and Crea
Hyperphosphatemia
Hyperkalemia
Increased PCV
Increased Total protein 
Serum glycolic acid
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15
Q

What is a typical clinical pathology finding for Ethylene glycol toxicosis?

A

Anion gap more than 40-50mEq/L

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16
Q

What can cause a False positive on a Kasey EG Test Kit?

A 
Propylene glycol 
Mannitol 
Sorbitol 
Glycerol 
Ethanol
17
Q

What is special about the Catachem Ethylene Glycol test?

A

No false positive with Ethanol

18
Q

What can you sometimes use to examine the oral cavity, face, paws, vomitus, and urine?

A

Woods Lamp to fluoresce Sodium Fluorescein

19
Q

What is the treatment for Ethylene glycol toxicosis?

A

Detoxification: Activated charcoal
inhibitors of alcohol dehydrogenase
Fomepizole
Ethanol

20
Q

What is a down side to using Ethanol as a treatment for Ethylene glycol toxicosis?

A

Causes CNS depression and increases blood osmolality

21
Q

What is an advantage to using Fomepizole as a treatment for Ethylene glycol toxicosis?

A

It does not interfere with Ethylene glycol tests

22
Q

Fomepizole

A

inhibitor of alcohol dehydrogenase

RUSVM Toxicology 2016 (32 decks)

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