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What is Oxalate crystals in urine is seen in poisoning with and explain in detail?
Ans: b (Ethylene glycol)Ref: Harrison, 17 ed. pg. 291, Davidson 21 ed. pg.Ethylene glycol poisoning (Antifreeze)Ethylene glycol is metabolized into glycoaldehyde, glycolic acid, glycoxylic acid, oxalic acid causing metabolic acidosis; oxalate causes renal damage due to calcium oxalate crystals in urine.C/F: Ophthalmpoplegia, cranial nerve palsies, myoclonus, hyporeflexia renal failureManagement* Assay not widely available* Diagnosed by the presence of high anion gap, osmolal gap> 10 mOsm and presence of oxalate crystals in urine* Antidote - Oral ethanol, Fomipazole -Inhibit alcohol dehydrogenase* Hemodialysis in severe cases* Hypocalcaemia treated only if severe ECG changes/ seizures present