Which statement about aspirin overdose is true?

Which statement about aspirin overdose is true?

• A. Metabolic acidosis is the earliest change.
• B. Respiratory alkalosis is common early.
• C. Tinnitus is never present.
• D. All symptoms occur only after 24 hours.

Answer: (B)

In aspirin (salicylate) overdose, the first thing that happens is stimulation of the medullary respiratory center, which makes you hyperventilate. That rapid breathing blows off CO2 and creates an early respiratory alkalosis. As the salicylates continue to accumulate, metabolism becomes disrupted and a high anion gap metabolic acidosis develops from buildup of organic acids like lactic acid. Tinnitus is a classic and common symptom, not something that never occurs, and symptoms often appear within hours rather than waiting a full day. So the statement that respiratory alkalosis is common early is the true one.

In aspirin (salicylate) overdose, the first thing that happens is stimulation of the medullary respiratory center, which makes you hyperventilate. That rapid breathing blows off CO2 and creates an early respiratory alkalosis. As the salicylates continue to accumulate, metabolism becomes disrupted and a high anion gap metabolic acidosis develops from buildup of organic acids like lactic acid. Tinnitus is a classic and common symptom, not something that never occurs, and symptoms often appear within hours rather than waiting a full day. So the statement that respiratory alkalosis is common early is the true one.