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Practice sessionHEALTHCARE & MEDICAL EXAMSMEDICAL LICENSING

USMLE (United States Medical Licensing Examination) Practice Exam 13

Practice exam for USMLE (United States Medical Licensing Examination).

Active sessionUSMLE practice testUSMLE practice examUSMLE practice questionsUnited States Medical Licensing Examinationmedical licensing exam+6
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Question 1 of 1000%
Time remaining120:00
Attempts allowedUnlimited
Difficulty mixE • M • H
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Question 1

MEDIUM

A 24-year-old man is brought to the emergency department after being found unresponsive at home. He has a history of opioid use disorder. Respirations are 6/min and shallow. Arterial blood gas on room air shows: pH 7.22, PaCO2 68 mm Hg, PaO2 72 mm Hg, HCO3− 26 mEq/L (reference 22–26). After receiving naloxone, his respiratory rate improves. Which of the following acid–base changes is most likely to occur over the next 24–48 hours if hypoventilation had persisted without treatment?

Persistent respiratory acidosis triggers renal compensation: increased proximal tubular ammoniagenesis and increased H+ secretion, raising serum HCO3− over 1–2 days. Decreased H+ secretion or bicarbonate reabsorption would worsen acidosis; carbonic anhydrase inhibition causes metabolic acidosis.

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