This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Pediatrics
[{'content': 'A two-year-old boy presents with fever for 3 days which responded to administration of paracetamol. Three days later he developed acute renal failure, marked acidosis and encephalopathy. His urine showed plenty of oxalate crystals. The blood anion gap and osmolar gap were increased. Which of the following is the most likely diagnosis – \nSelect and explain. \nA. Paracetamol poisoning, B. Diethy glycol poisoning, C. Severe malaria, D. Hanta virus infection', 'role': 'user'}, {'content': 'Answer: B \nExplanation: ETHYLENE GLYCOL POISONING\n\nEthylene glycol is metabolized by Alcohol dehydrogenate in the liver to\nGlycoaldehyde → Glyoxalic acid → Oxalic acid\nToxicity is caused by oxalic acid\nToxicity occurs in 3 stages\nEarly symptoms (1-12 hr) - Gastric irritation, nausea, Vomiting, drowsiness, metabolic acidosis begins to develop.\nSymptoms at 12-24 hours - Cardiac dysrhythmia, muscle pain, tetany due to hypocalcaemia which occur due to binding and calcium with oxalic acid.\nLater stage (After 24 hrs) - Cardiac failure, seizure, cerebral edema and renal failure.\nRenal failure is caused due to deposition of calcium oxalate crystal in renal tubules.\nCalcium oxalate crystals are commonly seen in urine on microscopy.\n\nManagement -\n\nIntravenous sodium bicarbonate at doses of 1-2 mEq/Kg.\nEthanol and/or Fomepizole to inhibit the metabolism of ethylene glycol.\nHemodialysis effectively removes ethylene glycol.', 'role': 'assistant'}]