A 34-year-old woman preparing for a high-altitude trek is started on acetazolamide prophylaxis. She presents with BP 118/76 mmHg, HR 88/min, RR 20/min, and SpO2 98% on room air. Serum bicarbonate is 20 mEq/L (normal 22-26). She denies dyspnea or chest pain. Which of the following acid-base disturbances is most likely to occur shortly after initiating acetazolamide?

  1. A)Respiratory alkalosis
  2. B)Metabolic alkalosis
  3. C)Respiratory acidosis
  4. D)Normal anion gap metabolic acidosisGABARITO
  5. E)High anion gap metabolic acidosis

Explicação

Normal anion gap metabolic acidosis is correct. Acetazolamide inhibits carbonic anhydrase in the proximal tubule, reducing bicarbonate reabsorption and causing bicarbonaturia. The resulting metabolic acidosis helps stimulate ventilation and is useful for altit... Ver explicação completa e trilha adaptativa →

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