question: Q:A 36-year-old man is brought to the emergency department by a neighbor with signs of altered mental status. He was found 6 hours ago stumbling through his neighbor's bushes and yelling obscenities. The neighbor helped him home, but found him again 1 hour later slumped over on his driveway in a puddle of vomit. He is oriented to self, but not to place or time. His vitals are as follows: temperature, 36.9°C (98.5°F); pulse, 82/min; respirations, 28/min; and blood pressure, 122/80 mm Hg. Cardiopulmonary examination indicates no abnormalities. He is unable to cooperate for a neurological examination. Physical examination reveals muscle spasms involving his arms and jaw. Laboratory studies show:
  Na+ 140 mEq/L
  K+ 5.5 mEq/L
  CI- 101 mEq/L
  HCO3- 9 mEq/L
  Urea nitrogen 28 mg/dL
  Creatinine 2.3 mg/dL
  Glucose 75 mg/dL
  Calcium 7.2 mg/dL
  Osmolality 320 mOsm/kg
  The calculated serum osmolality is 294 mOsm/kg. The arterial blood gas shows a pH of 7.25 and a lactate level of 3.2 mmol/L. Urine examination shows oxalate crystals and the absence of ketones. What is the most appropriate treatment indicated for this patient experiencing apparent substance toxicity?? 
  {'A': 'Ethanol', 'B': 'Fomepizole', 'C': 'Hydroxocobalamin', 'D': 'Methylene blue', 'E': 'N-acetyl cysteine'},