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CVPR Pulmonary (Exam 3) > High Altitude and Diving > Flashcards

High Altitude and Diving Flashcards

1
Q

What is chronic mountain sickness (CMS)?

A

polycythemia with PHTN due to high altitude resistance

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2
Q

In ______, the feature is exuberant pulmonary hypertension (PHTN) in response to acute hypoxia.

A

High Altitude Pulmonary Edema (HAPE)

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2
Q

Atmospheric (or barometric) pressure increases by 1 atm for every ____ meters of depth in sea water.

A

10

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2
Q

What is the tx for decompression sickness/the bends?

A

recompression in a hyperbaric chamber

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4
Q

What is adaptation?

A
  • a genetic event that increases tolerance
  • occurs only in populations over generations
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4
Q

What are the s/s of Acute Mountain Sickness (AMS)?

A
  • headache
  • nausea
  • malaise
  • insomnia
  • anorexia
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5
Q

What is pulmonary barotrauma?

A

pneumomediastinum or pneumothorax caused by gas pushed into the interstitium

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6
Q

What are the s/s of High Altitude Cerebral Edema (HACE)?

A
  • ataxia
  • confusion/combativeness
  • hallucinations
  • coma
  • (presents similarly to intoxication)
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7
Q

This is the most extreme form of acute mountain sickness and is a medical emergency.

A

High Altitude Cerebral Edema (HACE)

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7
Q

What are the s/s of pneumomediastinum?

A
  • substernal chest pain
  • cough
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8
Q

One of the earliest physiological changes that occurs when humans are exposed to acute hypoxia is to ____.

A

increase blood flow (cardiac output)

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9
Q

What is the value of water vapor pressure?

A

47

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10
Q

In High Altitude Pulmonary Edema (HAPE) a main feature is _____ in response to acute hypoxia.

A

pulmonary hypertension (PHTN)

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11
Q

An increase in HR occurs within _____ of hypoxia exposure.

A

minutes

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11
Q

Increased VE can last for _____, and is thus the most useful short term adaptive response to high altitude exposure.

A

days and weeks

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12
Q

This is a non-cardiogenic pulmonary edema- a life threatening complication of altitude exposure.

A

High Altitude Pulmonary Edema (HAPE)

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13
Q

What are the s/s of pneumothorax?

A
  • dyspnea
  • unilateral chest pain
  • cough
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14
Q

_____ can last for days and weeks, and is thus the most useful short term adaptive response to high altitude exposure.

A

Increased VE

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15
Q

What is dexamethasone?

A

a steroid used to treat HACE

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15
Q

This is pneumomediastinum or pneumothorax caused by gas pushed into the interstitium.

A

pulmonary barotrauma

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16
Q

What is the best mechanism for long-term adaptation to high altitude?

A
  • to increase hemoglobin and red cell mass
  • decrease plasma volume
16
Q

What underlying disease increases the risk of barotrauma?

A

asthma

16
Q

The longer and deeper the dive, the more concern for _____.

A

decompression sickness/the bends

16
Q

What is shallow water blackout?

A

breath holding dives that result in loss of consciousness

17
Q

What is the barometric pressure in Denver?

A

630

18
Q

What is High Altitude Pulmonary Edema (HAPE)?

A
  • a non-cardiogenic pulmonary edema
  • a life threatening complication of altitude exposure
20
Q

______ is caused by an increase in brain volume in response to hypoxia that may be due to cerebral edema and/or increased cerebral blood flow/intravascular volume.

A

Acute Mountain Sickness (AMS)

21
Q

______ is a genetic event to increase tolerance and thus occurs only in populations over generations.

A

Adaptation

23
Q

What is VE?

A

minute ventilation

24
Q

What is nitrogen narcosis?

A
  • clumsiness
  • bizarre behavior
  • euphoria
  • unconsciousness
  • **** caused by breathing compressed air (>75% N) at depths >100 feet
26
Q

If acute hypoxia is severe in the unacclimatized, the person rapidly becomes ______.

A

unconscious

28
Q

The diffusion of O2 across the alveolar-capillary membrane is dependent on ______ and _______.

A

its thickness; the concentration of Hb

29
Q

The _______ across the alveolar-capillary membrane is dependent on its thickness and the concentration of Hb.

A

diffusion of O2

30
Q

What are the s/s of nitrogen narcosis?

A
  • clumsiness
  • bizarre behavior
  • euphoria
  • unconsciousness
31
Q

What are the s/s of decompression sickness/the bends?

A
  • confusion
  • musculoskeletal pain
  • dyspnea
  • stroke
  • coma
  • seizures
  • paralysis
  • death
33
Q

What is acclimatization?

A

a subacute to chronic physiologic process that permits more efficient function at altitude

35
Q

In persons that have _____, the ventilatory responses to both hypoxia and to higher PaCO2 are exaggerated.

A

acclimatized to high altitude

37
Q

In persons that have acclimatized to high altitude, the ventilatory responses to both hypoxia and to higher PaCO2 are _____.

A

exaggerated

38
Q

What is the tx for High Altitude Cerebral Edema (HACE)?

A
  • supportive
  • IV dexamethasone
39
Q

Acute mountain sickness (AMS) is caused by ______ in response to hypoxia that may be due to cerebral edema and/or increased cerebral blood flow/intravascular volume.

A

an increase in brain volume

40
Q

What causes decompression sickness/the bends?

A

inert gases supersaturate the tissues and then the diver ascends too rapidly

41
Q

The best initial way to increase hemoglobin saturation (and thus tissue oxygen delivery) is to _____.

A

hyperventilate

42
Q

Acute mountain sickness (AMS) is caused by an increase in brain volume in response to hypoxia that may be due to ______ and/or _____.

A

cerebral edema; increased cerebral blood flow/intravascular volume

43
Q

A “left shift” in the O2-Hb dissociation curve occurs due to _____.

A

respiratory alkalosis (hyperventilation/decreased PaCO2)

45
Q

A “____ shift” in the O2-Hb dissociation curve occurs due to respiratory alkalosis (hyperventilation/decreased PaCO2).

A

left

46
Q

What is High Altitude Cerebral Edema (HACE)?

A

the most extreme form of acute mountain sickness- a medical emergency

47
Q

What is the tx for Acute Mountain Sickness (AMS)?

A
  • analgesics
  • oral dexamethasone (a corticosteroid) OR oral acetazolamide
48
Q

What is the tx for High Altitude Pulmonary Edema (HAPE)?

A
  • decent to lower altitude
  • supplemental O2
  • vasodilators (nifedipine, tadalafil)
  • salmeterol
49
Q

This is clumsiness, bizarre behavior, euphoria, and unconsciousness caused by breathing compressed air (>75% N) at depths >100 feet.

A

nitrogen narcosis

50
Q

This is caused by breath holding dives that result in loss of consciousness.

A

shallow water blackout

51
Q

______ is a subacute to chronic physiologic process that permits more efficient function at altitude.

A

Acclimatization

52
Q

This is polycythemia with PHTN due to high altitude resistance.

A

chronic mountain sickness (CMS)

CVPR Pulmonary (Exam 3) (42 decks)

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