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A homeless middle-aged male patient presents in the emergency room in a state of intoxication. You note that he is behaviorally disinhibited and rowdy. He tells you that he has recently consumed about a pint of a red-colored liquid that his friends were using to "get high". He complains that his vision has blurred and that it is "like being in a snowstorm". His breath smells a bit like formaldehyde. The most likely cause of his intoxicated state is the ingestion of

A ethylene glycol

B ethanol

C isopropanolol

D methanol

E hexane

d.........................

D.. Behavioral desinhibition is a feature of early intoxication due to ethanol and most other alcohols, but not ingestion of the solvent, hexane. Ocular dysfunction, including horizontal nystagmus and diplopia, is also a common finding in poisoning with alcohols, but the complaint of "flickering white spots before the eyes" or "being in a snowstorm" is pathognomonic for methanol intoxication. In some cases, the odor of formaldehyde may be present on the breath. In the patient, blood methanol levels should be determined as soon as possible........POSTED BY MEHRBAN

D....methanol