Urine microscopy showing calcium oxalate crystals in the urine As many of the clinical signs and symptoms of<unk>  are nonspecific and occur in many poisonings the diagnosis is often difficult. It is most reliably diagnosed by the measurement of the blood<unk><unk>  concentration.<unk><unk>  in biological fluids can be determined by gas chromatography. Many hospital laboratories do not have the ability to perform this blood test and in the absence of this test the diagnosis must be made based on the presentation of the person. In this situation a helpful test to diagnose poisoning is the measurement of the osmolal gap. The person' serum osmolality is measured by freezing point depression and then compared with the predicted osmolality based on the person's measured sodium, glucose, blood urea nitrogen, and any ethanol that may have been ingested. The presence of a large osmolal gap supports a diagnosis of<unk> . However, a normal osmolar gap does not rule out<unk><unk>  exposure because of wide individual variability. The increased osmolal gap is caused by the<unk><unk>  itself. As the metabolism of<unk><unk>  progresses there will be less<unk><unk>  and this will decrease the blood<unk><unk>  concentration and the osmolal gap making this test less useful. Additionally, the presence of other alcohols such as ethanol, isopropanol, or methanol or conditions such as alcoholic or diabetic ketoacidosis, lactic acidosis, or kidney failure may also produce an elevated osmolal gap leading to a false diagnosis. Other laboratory abnormalities may suggest poisoning, especially the presence of a metabolic acidosis, particularly if it is characterized by a large anion gap. Large anion gap acidosis is usually present during the initial stage of poisoning. However, acidosis has a large number of differential diagnosis, including poisoning from methanol, salicylates, iron, isoniazid, paracetamol, theophylline, or from conditions such as uremia or diabetic and alcoholic ketoacidosis. The diagnosis of<unk>  should be considered in any people with a severe acidosis. Urine microscopy can reveal needle or envelope-shaped calcium oxalate crystals in the urine which can suggest poisoning; although these crystals may not be present until the late stages of poisoning. Finally, many commercial radiator antifreeze products have fluorescein added to enable radiator leaks to be detected using a Wood's lamp. Following ingestion of antifreeze products containing<unk><unk>  and fluorescein, a Wood's lamp may reveal fluorescence of a person's mouth area, clothing, vomitus, or urine which can help to diagnose poisoning.
Ethylene glycol poisoning
Salicylate poisoning
Strychnine poisoning
Tin poisoning
Theobromine poisoning
Organophosphate poisoning
Sulfuric acid poisoning
Chlorine gas poisoning