Q. A 33-year-old woman presets to the Emergency Department with severe abdominal pain. She admits to consuming approximately nine alcoholic drinks while partying with friends earlier in the evening. When getting a medical history, she informs the tech that she takes diuretics each day to “lose water weight.” She admits to being unusually anxious but chalks that up to the pain and the anxiety of an ED visit. Physical examination reveals periumbilical tenderness upon palpation. She denies vomiting and states her stool and urine appear normal. Arterial blood gas analysis reveals a pH of 7.55, a bicarbonate level of 21 mEq/L, and a ppCO2 of 25mm/Hg. Which of the following is likely causing her acid-base disturbance?