Aeromedial Internal Medicine Flashcards
List the 6 parts of the aeromedical review process
- Define aeromedical events of concern
- Determine annual event rate
- Determine threshold of acceptable risk (1% rule)
- Define recertification/re-evaluation policy
- Consider impact of medical therapy
- Identify special considerations
List 5 special considerations for military aviation
- Single-pilot vs multi-place aircraft
- Category of aircrew
- High-G environment
- Very high altitude flight
- Mission completion
What is the initial management of asymptomatic HTN?
May continue to fly for 6 months while undergoing 6 months of lifestyle changes
List 3 classes of approved anti-HTN medications.
- Diuretics (thiazide, potassium sparing)
- ACE-I
- ARBs
Describe condition when HTN does not need a waiver
Uncomplicated HTN controlled on single approved med
How is HCTZ/Triamterene considered?
As mono therapy for waiver purposes
It is okay to start an ARB after an ACE-I. How long should you wait? Why?
3-4 weeks as angioedema from ACE-I can still occur that far out. Don’t want it to be attributed to the ARB.
If a patient requires a beta-blocker or CCB (DHP only), what waiver restriction will they be given?
Non-high performance aircraft
Why are non-DHP calcium channel blockers considered non-waiverable?
Non-DHP CCB are negative chronotropes and inotropes
Are alpha-blockers waiverable?
No
When does GERD not require a waiver?
Uncomplicated, tx with ppi
When does HLP treatment not require waiver?
Single approved statin (+/- fish oil)
When can DM2 be wavered? With what restrictions?
When treated with diet controlled (unrestricted) or metformin (with another qualified pilot)
What is the status of glucose intolerance?
Not disqualifying
List 5 items that must be evaluated in DM2.
- BP
- Lipids
- DFE
- Albumin-to-creatinine ratio
- Monofilament foot exam
What is the diagnostic criteria for hypogonadism? What is key item pertaining to lab draw?
Total testosterone < 300 on two occasions.
Lab must be drawn at 0800.
If a patient’s testosterone level is low, what is the next step? What is the interpretation?
Draw FSH/LH.
If increased– primary failure
If decreased– secondary failure– check MRI sella, TSH, prolactin
What is the treatment for hypogonadism?
Transdermal
Injection
What 5 items must be surveilled for in patients with hypogonadism?
- OSA
- LFTs
- Lipids
- H/H
- PSA + prostate exam
What error is made with respect to rheumatoid arthritis in aviators?
Under-treat disease to avoid DQ
List 4 aeromedical considerations with respect to cancer
- Complications of tx (i.e. chemo)
- Return to baseline fn
- Risk of recurrence (? brain mets)
- Required monitoring
