toxicology - she

[ArchivalUser]

A 23 yr old woman is brought to the emergency room from a half way house,where she had apparently swallowed a handful of pills. The patient complaints of shortness of breath and tinnitus, but refuses to identify the pill.lab values are.
Ph- 7.45,po2 126, pco2 12
serum electrolytes- Na 138, K 4.8 cl 102 HCO3 8
1 the patienta acid base disturbance is best characterized by
a acute respiratory alkalosis , compensated
b chronic respiratory alkalosis , compensated
c metabolic acidosis compensated
d mixed metabolic acidosis and resp alkalosis
e mixed metab acidosis and res acidosis

2 the most likely cause of the disturbance is due to overdose of
a phenformin
b aspirin
c barbiturates
d methanol
e diazepam

[ArchivalUser]

d mixed metabolic acidosis and resp alkalosis


b aspirin

[ArchivalUser]

I think it's D and B too, but isn't it mixed resp alkalosis and met acidosis? In other words, don't you have to look at the predominant disturbance first?

[ArchivalUser]

1.D
2.B

[ArchivalUser]

d mixed metabolic acidosis and resp alkalosis

b aspirin

[ArchivalUser]

the ans is D and B, the disturbance cannot be pure resp alkalosis,since the serum bicarbonate doent drop below 15 meq/l as a result of renal compensation, and it is aspirin as it directly stimulates the resp centers and produces resp alkalosis and by building up organic acids it produces metabolic acidosis