Heme Review | The Body After Drinking A Snowglobe @HemeReview | Uploaded 4 years ago | Updated 1 hour ago
A Dad Mistakenly Drank A Snowglobe. This Is What Happened To His Kidneys: youtu.be/UrbylXMU8Mw
A Man Drank 2 Liters Moonshine In 2 Hours. This Is what Happened To His Brain: youtu.be/4DQUrg0Yhu4
The Body After Drinking 2 Gallons Coffee In 3 Hours: youtube.com/watch?v=rn-WLpa_nyQ&list=PLAHeV2H_YiGUYhHOF4wRMCuqBIJvrnWqS&index=6&t=1s
All Heme Review episodes (playlist): youtube.com/playlist?list=PLAHeV2H_YiGUYhHOF4wRMCuqBIJvrnWqS
Tweet me: twitter.com/hemereview
FB me: facebook.com/hemereview
IG me: instagram.com/hemereview
Music by Lifeformed ► lifeformed.bandcamp.com
Music by T4N3 ► soundcloud.com/t4n3
Additional photos courtesy Radiopaedia.org, and Wellcome Collection.
Pathology slides courtesy BMJ Case Reports, September 12 2019
Most snowglobes are just made of water, but some can contain ethylene glycol. Most of those usually don't contain enough ethylene glycol to cause damage, but keep the word "usually" in mind. A homemade snowglobe can contain concentrations of anything, which is what happened in this case.
Ethylene glycol can cause a profound high anion gap metabolic acidosis, and we'll explain the science, chemistry and physiology behind that in this episode.
References:
Delayed ethylene glycol presenting with abdominal pain and multiple cranial and peripheral neuropathies: a case report. Journal of Medical Case Reports volume 4, Article number: 220 (2010).
Multiple Cranial Nerve Deficits After Ethylene Glycol. Ann Emerg Med. 1991 Feb;20(2):208-10. pubmed.ncbi.nlm.nih.gov/1996809
Antidotes OH that form toxic metabolites. Br J Clin Pharmacol. 2016 Mar; 81(3): 505–515. ncbi.nlm.nih.gov/pmc/articles/PMC4767193
Toxic Alcohols. N Engl J Med 2018; 378:270-280. nejm.org/doi/full/10.1056/NEJMra1615295
Ethylene glycol ingestion masked by concomitant ethanol ingestion. Case Reports 2012;2012:bcr1220115326. casereports.bmj.com/content/2012/bcr.12.2011.5326
Challenges in the Diagnosis of Ethylene Glycol Poisoning. Ann Clin Biochem. 2014 Mar;51(pt2):167-78. pubmed.ncbi.nlm.nih.gov/24215789
Emmett M, Narins RG. Clinical use of the anion gap. Medicine (Baltimore) 1977;56:38-54.
Uribarri J, Oh MS, Carroll HJ. D-lactic acidosis: a review of clinical presentation, biochemical features, and pathophysiologic mechanisms. Medicine (Baltimore) 1998;77:73-82.
Judge BS. Metabolic acidosis: differentiating the causes in the poisoned patient. Med Clin North Am 2005;89:1107-1124.
Kosten TR, O’Connor PG. Management of drug and alcohol withdrawal. N Engl J Med 2003;348:1786-1795. nejm.org/doi/full/10.1056/NEJMra020617
A 49 Year Old Man With Obtundation Followed By Agitation And Acidosis. N Engl J Med 2015; 372:465-473. nejm.org/doi/full/10.1056/NEJMcpc1410940
Integration of Acid-Base And Electrolyte Disorders. N Engl J Med 2014; 371:1821-1831. nejm.org/doi/full/10.1056/NEJMra1215672
Calcium Kidney Stones. N Engl J Med 2010; 363:954-963. nejm.org/doi/full/10.1056/NEJMcp1001011
A Dad Mistakenly Drank A Snowglobe. This Is What Happened To His Kidneys: youtu.be/UrbylXMU8Mw
A Man Drank 2 Liters Moonshine In 2 Hours. This Is what Happened To His Brain: youtu.be/4DQUrg0Yhu4
The Body After Drinking 2 Gallons Coffee In 3 Hours: youtube.com/watch?v=rn-WLpa_nyQ&list=PLAHeV2H_YiGUYhHOF4wRMCuqBIJvrnWqS&index=6&t=1s
All Heme Review episodes (playlist): youtube.com/playlist?list=PLAHeV2H_YiGUYhHOF4wRMCuqBIJvrnWqS
Tweet me: twitter.com/hemereview
FB me: facebook.com/hemereview
IG me: instagram.com/hemereview
Music by Lifeformed ► lifeformed.bandcamp.com
Music by T4N3 ► soundcloud.com/t4n3
Additional photos courtesy Radiopaedia.org, and Wellcome Collection.
Pathology slides courtesy BMJ Case Reports, September 12 2019
Most snowglobes are just made of water, but some can contain ethylene glycol. Most of those usually don't contain enough ethylene glycol to cause damage, but keep the word "usually" in mind. A homemade snowglobe can contain concentrations of anything, which is what happened in this case.
Ethylene glycol can cause a profound high anion gap metabolic acidosis, and we'll explain the science, chemistry and physiology behind that in this episode.
References:
Delayed ethylene glycol presenting with abdominal pain and multiple cranial and peripheral neuropathies: a case report. Journal of Medical Case Reports volume 4, Article number: 220 (2010).
Multiple Cranial Nerve Deficits After Ethylene Glycol. Ann Emerg Med. 1991 Feb;20(2):208-10. pubmed.ncbi.nlm.nih.gov/1996809
Antidotes OH that form toxic metabolites. Br J Clin Pharmacol. 2016 Mar; 81(3): 505–515. ncbi.nlm.nih.gov/pmc/articles/PMC4767193
Toxic Alcohols. N Engl J Med 2018; 378:270-280. nejm.org/doi/full/10.1056/NEJMra1615295
Ethylene glycol ingestion masked by concomitant ethanol ingestion. Case Reports 2012;2012:bcr1220115326. casereports.bmj.com/content/2012/bcr.12.2011.5326
Challenges in the Diagnosis of Ethylene Glycol Poisoning. Ann Clin Biochem. 2014 Mar;51(pt2):167-78. pubmed.ncbi.nlm.nih.gov/24215789
Emmett M, Narins RG. Clinical use of the anion gap. Medicine (Baltimore) 1977;56:38-54.
Uribarri J, Oh MS, Carroll HJ. D-lactic acidosis: a review of clinical presentation, biochemical features, and pathophysiologic mechanisms. Medicine (Baltimore) 1998;77:73-82.
Judge BS. Metabolic acidosis: differentiating the causes in the poisoned patient. Med Clin North Am 2005;89:1107-1124.
Kosten TR, O’Connor PG. Management of drug and alcohol withdrawal. N Engl J Med 2003;348:1786-1795. nejm.org/doi/full/10.1056/NEJMra020617
A 49 Year Old Man With Obtundation Followed By Agitation And Acidosis. N Engl J Med 2015; 372:465-473. nejm.org/doi/full/10.1056/NEJMcpc1410940
Integration of Acid-Base And Electrolyte Disorders. N Engl J Med 2014; 371:1821-1831. nejm.org/doi/full/10.1056/NEJMra1215672
Calcium Kidney Stones. N Engl J Med 2010; 363:954-963. nejm.org/doi/full/10.1056/NEJMcp1001011
