368.A 24-year-old woman presents to the ED complaining of dizziness
and numbness and tingling in her fingertips with decreased range of motion.
Her initial vitals include a HR of 100 beats per minute, a RR of 30 breaths
per minute with an oxygen saturation of 100% on room air. The patient denies
any other symptoms. Upon physical examination, the patient appears anxious,
tachypneic with a clawed appearance to both hands which are difficult to
range. An arterial blood gas is drawn that shows a pH of 7.55 with a
decreased carbon dioxide level and normal bicarbonate level. Which of the
following underlying metabolic disturbances is responsible for this patient’s
symptoms?
a. Metabolic acidosis
b. Metabolic alkalosis
c. Respiratory acidosis
d. Respiratory alkalosis
e. Hyperthyroidism
384 Emergency Medicine