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  #1  
Old 03-02-2012
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Default Aspirin poisoning

A 26-year-old woman is brought to the
emergency department 3 hours after ingesting
approximately 50 tablets of aspirin in a suicide
attempt. She is nauseated, confused, and sleepy.
Her pulse is 130/min, respirations are 30/min,
and blood pressure is 100/60 mm Hg. Which of
the following sets of laboratory values is most
likely on evaluation of blood obtained before
treatment?
Serum Arterial Blood
HCO
3

pH PCO2

(A)
↑ ↓ ↑

(B)
↓ ↓ ↓

(C)
↑ ↑ ↓

(D)
↓ ↓ ↑

(E) ↑ ↑
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  #2  
Old 03-02-2012
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answer: C.....?
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  #3  
Old 03-02-2012
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B...it says after three hours so it has to be met acidosis.....(initial response is resp alkalosis)
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Old 03-02-2012
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Quote:
Originally Posted by drbedi View Post
B...it says after three hours so it has to be met acidosis.....(initial response is resp alkalosis)
im always confused about this.
can you give me a quick timeline of what happens after aspirin OD?
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Old 03-02-2012
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As usual - copying i pasting questions - messes up the tables guys...

but it should be firs respiratory alkalosis, but after 3 hours it will go into metabolic acidosis, due to uncoupling and accumulation of lactic acid and so on...

so i guess its B
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Old 03-02-2012
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I would go with C ,resp. alkalosis , as in uworld it says that after 3-4 hours metabolic acidosis starts so I think in 3 hours it has not started yet?????
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Quote:
Originally Posted by flowerlady View Post
I would go with C ,resp. alkalosis , as in uworld it says that after 3-4 hours metabolic acidosis starts so I think in 3 hours it has not started yet?????
She has ingested a lot of aspirin and since the symptoms have already started then it is already in her system.

Metabolic acidosis.
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Old 03-02-2012
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Quote:
Originally Posted by flowerlady View Post
I would go with C ,resp. alkalosis , as in uworld it says that after 3-4 hours metabolic acidosis starts so I think in 3 hours it has not started yet?????
I think that because in UW they gave a 3-4 hours interval, in this case we have to think that she is already in an acidotic state. I think that that is how they want to mess up with our minds: giving us a 3 hours presentation. We have to be careful, otherwise in this case they would have given a presentation <3 hours (Ex. 2.5 hours) if they where thinking alkalosis. A question can only have one answer, the best answer in this case will be acidotic.

So... I also go with B
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