Beta Blockers USMLE Step 1 Practice Question
A 19-year-old male college student is brought to the emergency department by his roommate after intentionally ingesting an entire bottle of aspirin approximately 2 hours ago following a breakup. On arrival, his temperature is 38.4°C, blood pressure is 110/70 mmHg, heart rate is 118 bpm, and respiratory rate is 32 breaths per minute. Physical examination reveals diffuse diaphoresis, bilateral tinnitus, and repeated episodes of vomiting. He is oriented to person only and appears agitated. Arterial blood gas demonstrates a pH of 7.46, PaCO2 of 28 mmHg, and bicarbonate of 19 mEq/L, consistent with a mixed respiratory alkalosis and metabolic acidosis. Serum salicylate level returns at 78 mg/dL. Which of the following interventions enhances elimination of the toxin by trapping it in the urine?
Answer choices
- AUrinary alkalinization with sodium bicarbonateCorrect answer
- BUrinary acidification with ammonium chloride
- CActivated charcoal only after 24 hours
- DIntravenous calcium gluconate
- EProtamine sulfate administration
- FHemodialysis with normal saline replacement
See the full explanation
Get the correct-answer rationale, why each distractor is wrong, the underlying mechanism, and high-yield associations — plus adaptive practice that targets your weak areas — with a free MedBoardPRO account.