Q. A 26-year-old female presents to the emergency department with complaints of dizziness and tingling (paresthesia) around her mouth and distal upper extremities. She denies any recent drug or alcohol use. Staff reports her symptoms have worsened since she arrived, and also inform you that the patient has demanded to “see a doctor immediately” because she is “dying”. On physical examination, the patient is visibly agitated, and demonstrates pressured speech and difficulty concentrating. Her blood pressure is 140/70 mm Hg, heart rate is 110/min, respiratory rate is 30/min, and her temperature is 37 degrees Celsius (96.8 degrees Fahrenheit). The patient is breathing shallow and rapidly (tachypnea), so you order a STAT arterial blood gas (ABG). Her ABG values on room air are as follows: pH 7.52, PaO2 90 mm Hg, SaO2 97 percent, PaCO2 25 mm Hg, and HCO3 18 mEq/L. Which of the following processes is most likely causing this patient’s acid-base imbalance?