A 52-year-old man is found confused in his garage beside an open antifreeze container. He presents with flank pain, oliguria, and altered mental status. Vital signs show BP 128/82, HR 102, RR 20, temperature 37.2°C, and SpO2 98% on room air. Urinalysis reveals envelope-shaped calcium oxalate crystals and hematuria. Serum creatinine is 3.2 mg/dL. He denies recent acetaminophen use. Which toxic metabolite is primarily responsible for his acute kidney injury?
- A)NAPQI
- B)Acetaldehyde
- C)Cyanide ion
- D)Formic acid
- E)Oxalic acidGABARITO
Explicação
Ethylene glycol is metabolized to glycolic and oxalic acids. Oxalic acid forms calcium oxalate crystals that injure the kidneys, producing renal failure and envelope-shaped crystals in the urine. Ver explicação completa e trilha adaptativa →