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Salicylate toxicity — ABEM Board MCQ

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HardToxicologySalicylate toxicityABEM Board

A 58-year-old man arrives with tinnitus, vomiting, and tachypnea after taking many aspirin tablets. Triage acuity is ESI 2; BP 132/76 mm Hg, HR 118/min, RR 34/min. ABG shows pH 7.49 with low PaCO2; chemistry shows bicarbonate 16 mEq/L and an anion gap of 24. Which of the following is the most likely diagnosis?

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Correct answer: B — Salicylate poisoning

Tinnitus, vomiting, hyperventilation, respiratory alkalosis with anion-gap metabolic acidosis suggest salicylate toxicity.

Reference: ACMT salicylate poisoning guidance