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USMLE (United States Medical Licensing Examination) Practice Exam 14

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

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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 26-year-old woman presents with progressive fatigue and shortness of breath for 2 weeks. She recently returned from a hiking trip at high altitude. She has no past medical history and takes no medications. Vital signs are temperature 36.9°C (98.4°F), blood pressure 112/70 mm Hg, pulse 92/min, respirations 20/min, and oxygen saturation 92% on room air. Arterial blood gas shows pH 7.48, PaCO2 30 mm Hg, PaO2 62 mm Hg, HCO3− 22 mEq/L. Which of the following is the most likely acid–base change expected after 3 days if she remains at the same altitude?

High altitude causes hypoxemia → hyperventilation → respiratory alkalosis (low PaCO2). Over 2–3 days, kidneys compensate by excreting bicarbonate, lowering HCO3− toward normal. Hypoventilation would worsen hypoxemia, and diarrhea is not implicated.

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