Wednesday, April 16, 2008

Long Island

It's another long day at the laboratory, staring at blood smears, culturing bacteria, analyzing blood gases. At about 3PM, your intern says, "Oh no! I've got to run. Can you take a look at this last sample for me? I really got a family emergency." He hands you an unlabeled specimen, grabs his golf clubs, and rushes out the door.

You have no idea what this is, but you take a look at it under the microscope:

Finally, you locate the doctor who sent this sample in. After telling him your impression, he says, "I knew it! This guy was brought in after a suicide attempt, and I was sure he drank a gallon of that stuff. I'm gonna get him a Long Island Iced Tea. You want one too?"

Challenge: Before you celebrate, you should be able to explain how the Long Island Iced Tea would help the patient.

Related Questions:
1. What are you looking at? What does the image show?
2. How did the person attempt suicide? What did he drink?

Image shown under fair use.


Alex said...

methanol in antifreeze? alcohol competitively inhibits methanol metabolism to prevent blindness

Craig said...

Long Island

This is an image of calcium oxalate dihydrate crystals in the urine. The most likely cause of oxalate crystals in the urine is antifreeze (ethylene glycol) poisoning - this is probably what the person drank in his suicide attempt. Ethylene glycol is converted by alcohol dehydrogenase to toxic metabolites. The Long Island Iced Tea would help because ethanol is a competitive inhibitor of alcohol dehydrogenase. This limits formation of toxic metabolites; ethylene glycol can be excreted harmlessly. Gastric lavage would also be performed, and fomepizole (also an alcohol dehydrogenase antagonist) can be given.

Sources: Wikipedia; Washington State University College of Veterinary Medicine Website.