A 19-year-old college student is brought to the emergency department after intentionally ingesting a bottle of aspirin tablets. He presents with tinnitus, nausea, and tachypnea (RR 28/min). Vital signs show BP 138/85 mm Hg, HR 102/min, temp 38.2°C, SpO2 98% on room air. Arterial blood gas reveals pH 7.47, PaCO2 24 mm Hg, HCO3- 17 mEq/L, and serum salicylate level 89 mg/dL. No altered mental status is currently noted. Which acid-base disturbance best explains these findings?
- A)Respiratory acidosis only
- B)Respiratory alkalosis with anion gap metabolic acidosisGABARITO
- C)Nonanion gap metabolic acidosis only
- D)Metabolic alkalosis only
- E)Respiratory acidosis with metabolic alkalosis
Explicação
Salicylate toxicity classically causes an early respiratory alkalosis from medullary respiratory center stimulation followed by an anion gap metabolic acidosis from organic acid accumulation. Tinnitus and tachypnea are high yield clues for aspirin poisoning. Ver explicação completa e trilha adaptativa →