Toxicology: salicylate poisoning: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Toxicology: salicylate poisoning

Sample item

A patient with salicylate toxicity has tinnitus, tachypnea, and an arterial blood gas showing respiratory alkalosis with high-anion-gap metabolic acidosis. What is the explanation?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Mixed respiratory alkalosis and metabolic acidosis

Salicylates stimulate respiration causing respiratory alkalosis and also produce metabolic acidosis through organic acid accumulation. The mixed pattern is a classic diagnostic clue.

Option by option

  • A. Pure respiratory acidosis

    Respiratory acidosis is the opposite of early salicylate ventilatory stimulation.

  • B. Mixed respiratory alkalosis and metabolic acidosis (correct)

    Correct. Both disorders occur together in significant salicylate toxicity.

  • C. Pure metabolic alkalosis

    Vomiting can cause alkalosis but does not explain the classic mixed disorder.

  • D. Normal acid-base physiology

    This acid-base pattern is abnormal and clinically important.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is B, Mixed respiratory alkalosis and metabolic acidosis. Salicylates stimulate respiration causing respiratory alkalosis and also produce metabolic acidosis through organic acid accumulation.

Why is "Pure respiratory acidosis" not the answer?

Respiratory acidosis is the opposite of early salicylate ventilatory stimulation.

Why is "Pure metabolic alkalosis" not the answer?

Vomiting can cause alkalosis but does not explain the classic mixed disorder.

Why is "Normal acid-base physiology" not the answer?

This acid-base pattern is abnormal and clinically important.

What concept does this question test?

It tests Toxicology: salicylate poisoning in General Medicine. The mixed pattern is a classic diagnostic clue.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Toxicology: salicylate poisoning?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.