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CDM > Altitude Sickness > Flashcards

Altitude Sickness Flashcards

1
Q

Above __ ft is when sig hypoxia occurs (Sats <90%)

A

1200ft

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2
Q

The__________

of oxygen stays the same in our atmosphere but the ____________is what changes

A
  1. percentage

2. partial pressure

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3
Q

Above _______ ft is considered the death zone as prolonged stay here results in hypoxia induced tissue
death.

A

22000

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4
Q

Acclimatization:
Step 1
First the ___________ detect hypoxia so it influences the medullary center to increase the respiratory
drive and increase your minute volume.

A

carotid body

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5
Q 
Acclimatization:
Step 2
Then you will have a \_\_\_\_\_\_\_\_\_\_ which will turn the medullary center on to \_\_\_\_\_\_\_\_\_ the
respiratory drive.
This happens after \_\_\_\_ days
A
  1. . Respiratory alkalosis
  2. decrease
  3. 1.5 days
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6
Q

Acclimatization:
Step 3
Now is when the ______ kick in and __________ to compensate for respiratory alkalosis ,

A
  1. kidneys

2. excrete bicarbonate

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7
Q

Acclimatization:
Step 4
Now
you can _______your ___ rate again .

A

increase RR rate

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8
Q

Acclimatization:
Step 5
Additionally, there is ___________ release with VC triggering suppression of ____ and ______ this
will result in a _______.

A
  1. catecholamine
  2. Aldosterone/ADH
  3. Diuresis
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9
Q

Acclimatization:
Step 5
You ________ the total number of rbc via _____ but this is late change and can take up to ___ days.

A

1 increase

  1. EPO
  2. 90
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10
Q

Acclimatization:

Enhancers (2)

A

Caffeine

Chocolate

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11
Q

Acclimatization:

Inhibitors (2)

A

ALCOHOL

sedatives

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12
Q

Acute Mountain Sickness prophylaxis

A

Acetazolamide

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13
Q

SxS Acute Mtn Sickness

Typically within __ hrs

A

n/v malaise and headache associated with hypoxia

48hrs

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14
Q

Is acute mtn sickness typically self-limited resolution of sx?

A

Yes

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15
Q

Can moderate cases of Acute mtn sickneesss stay at elevation?
When should they descend?

A

yes

High Lake Louise Score

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16
Q

What can happen if severe cases of acute mtn sickness dont descend?

A

HACE or HAPE

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17
Q

Descending ___m can be helpful w/ Acute mtn sickness symptoms?

A

500m

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18
Q

Syndromes of altitude range from ___ to ___

A

HAH to HACE

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19
Q

__ is the end stage process of acute mountain sickness: where there is vasodilation of capillary beds
then over perfusion

20
Q

HACE is results in _____ (loss of autoregulation of capillary beds) that eventually leads to ____

A

Vasogenic edema

Cell death

21
Q

HACE
Early manifestations:
Late Manifestations:

A

Early on manifested by headache, ataxia.

Later by altered mentation, lethargy, seizures, death

22
Q

Standard Tx of HACE

A

DESCEND!

O2, Acetazolaminde, dexamethazone, hyperbaric chamber

23
Q

If you cannot descend with HACE, second line (non rx)

A

portable hypobaric chamber

24
Q

Do oxygen, dexamethasone and acetazolamide prevent death in HACE?

A

No, they just delay it. NEED TO DESCEND

25
Q

__ is pulmonary edema not due to HF, but is ____ induced vasoconstriction.

A

HAPE

Hypoxia

26
Q

HAPE: periphery _____ and sum total. there is _____ of particular tissues causes capillary leak & _____.

A
  1. Vasodilates
  2. overperfusion
  3. edema
27
Q

HAPE can start at _____ft

28
Q

HAPE SxS

A

Cough
then dyspnea at rest
then crackles
then tachypnea

29
Q

Mild cases of HAPE can be treated with ___?

A

O2 and Nifedipine

30
Q

Moderate & severe cases of HAPE tx?

31
Q

HAPE pts with crackles regardless of O2 status Tx

32
Q

Takes __ days to acclimatize maximally

33
Q

Normal Physiologic Responses to Acclimatization

What happens to RAAS?

A

Suppressed

due to the bicarbonate diuresis and suppression of aldosterone.

34
Q

Normal Physiologic Responses to Acclimatization:

Vessels

A

Peripheral VC triggers baroreceptors (carotid sinus) to suppress secretion of ADH and aldosterone resulting in diuresis

35
Q

Normal Physiologic Responses to Acclimatization:

Lungs

A

Lung: Increase in Pulmonary vascular resistance
Pulmonary vessels constriction due to hypoxemia
Respiratory Rate Increased ventilation @ 4921 ft
There is an increase of oxygen delivery to the tissues

36
Q

O2 dissociation curve in response to acclimatization?

A

Shift to right- offload O2 to tissues easier.

37
Q

How does caffeine, cocoa, GC’s and Acetazolamine help you acclimatize?

A

Forced bicarbonate diuresis

38
Q

Does age/gender play a difference in altitude sickness?

39
Q

Lake Louise score 2-4

A

Mild

stop ascent
acetazolamide 125or 250mg bid

40
Q

Lake Louise Score

5-9

A

moderate

descend
O2

41
Q

Lake Louise Score

10-15

A

severe

O2
Acetazolamide 250 mg and dexamethasone 10mg
immediate descent
Pressure Bag (Gamow Bag)

42
Q

T/F: pts w/HACE can have weakness to a point of not being able to move
can have personality changes

43
Q

HAH Tx?

A

Stop ascent acclimatize
Acetazolamide 125 or 250mg bid
Or descend 500m

44
Q

T/F: HAPE pts can start to deteriorate over hours?

45
Q

Bottom line HAPE tx?

CDM (16 decks)

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