Soru

Paramedics are dispatched to the home of a 42-year-old man after he was discovered unresponsive in his garage. According to his husband, the patient has a history of severe depression and recently experienced a job loss. An empty, unlabeled container of sweet-smelling fluid was found nearby. Vital signs upon arrival at the hospital include a temperature of $36.5^\circ\text{C}$ ($97.7^\circ\text{F}$), blood pressure of $110/70 \text{ mm Hg}$, heart rate of $105/\text{min}$, and respiratory rate of $24/\text{min}$. The patient is obtunded, responding only by withdrawing from painful stimuli.

Laboratory studies are obtained:

Serum chemistry:
Sodium: $138 \text{ mEq/L}$
Potassium: $4.5 \text{ mEq/L}$
Chloride: $102 \text{ mEq/L}$
Bicarbonate: $12 \text{ mEq/L}$
Blood urea nitrogen (BUN): $28 \text{ mg/dL}$
Creatinine: $1.2 \text{ mg/dL}$
Glucose: $108 \text{ mg/dL}$

Arterial blood gas (room air):
pH: $7.22$
$\text{pCO}_2$: $26 \text{ mm Hg}$
$\text{pO}_2$: $95 \text{ mm Hg}$

Additional diagnostics:
Measured serum osmolality: $335 \text{ mOsm/kg H}_2\text{O}$

Based on the provided laboratory data, what is this patient's serum osmolar gap? (Enter the numerical value in $\text{mOsm/kg H}_2\text{O}$)