A 17-year-old girl presents to the emergency department after ingesting an entire bottle of aspirin two hours ago. She is tachypneic (RR 28/min), tachycardic (HR 118/min), and febrile (38.2°C). She complains of nausea, vomiting, and tinnitus. Blood pressure is 118/76 mmHg. Physical examination reveals no altered mental status. Serum salicylate level is 65 mg/dL. Arterial blood gas is most likely to show which acid-base pattern early in this poisoning?
- A)Metabolic alkalosis followed by respiratory acidosis
- B)Respiratory acidosis followed by metabolic alkalosis
- C)Normal acid base status with isolated hypernatremia
- D)Pure non anion gap metabolic acidosis only
- E)Respiratory alkalosis followed by an anion gap metabolic acidosisGABARITO
Explicação
Salicylates directly stimulate the respiratory center, causing an early respiratory alkalosis. As toxicity progresses, accumulation of organic acids produces an anion gap metabolic acidosis, creating the classic mixed disorder. Ver explicação completa e trilha adaptativa →