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Salicylate poisoning — MCCQE Part 1 MCQ

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HardPoisoning/OverdoseSalicylate poisoningMCCQE Part 1

A 45-year-old woman with tinnitus, vomiting and tachypnoea took many aspirin tablets. Blood gas shows mixed respiratory alkalosis and metabolic acidosis. Which of the following is the most appropriate management?

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Correct answer: D — Urinary alkalinization with sodium bicarbonate and toxicology consultation; consider haemodialysis if severe

Salicylate poisoning produces tinnitus, hyperventilation and mixed acid-base disturbance; bicarbonate alkalinizes serum and urine to reduce CNS penetration and enhance elimination. Severe poisoning, renal failure or altered mental status may require dialysis. Acetylcysteine treats acetaminophen toxicity, not salicylates.

Reference: Canadian toxicology practice; provincial poison centre guidance