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Multiple Choice

What is the disorder associated with alveolar hyperventilation from hypoxemia, fever, anemia, thyrotoxicosis, early salicylate intoxication, anxiety, or panic disorder?

Alveolar hyperventilation lowers the carbon dioxide level in the blood. CO2 is in balance with hydrogen ions through the carbonic acid–bicarbonate system, so when CO2 drops, hydrogen ion concentration falls and the blood becomes more alkaline. That’s respiratory alkalosis. The conditions listed—hypoxemia, fever, anemia, thyrotoxicosis, early salicylate intoxication, anxiety, or panic disorder—all tend to drive breathing faster or more shallowly, blowing off CO2 and producing this exact pattern. In an acute setting, pH rises with a normal or near-normal bicarbonate; with longer-standing hyperventilation, the kidneys compensate by reducing bicarbonate, which can bring pH back toward normal but the underlying cause remains increased ventilation leading to respiratory alkalosis.

Alveolar hyperventilation lowers the carbon dioxide level in the blood. CO2 is in balance with hydrogen ions through the carbonic acid–bicarbonate system, so when CO2 drops, hydrogen ion concentration falls and the blood becomes more alkaline. That’s respiratory alkalosis. The conditions listed—hypoxemia, fever, anemia, thyrotoxicosis, early salicylate intoxication, anxiety, or panic disorder—all tend to drive breathing faster or more shallowly, blowing off CO2 and producing this exact pattern. In an acute setting, pH rises with a normal or near-normal bicarbonate; with longer-standing hyperventilation, the kidneys compensate by reducing bicarbonate, which can bring pH back toward normal but the underlying cause remains increased ventilation leading to respiratory alkalosis.