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14 Cards in this Set
- Front
- Back
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What is Acute Mountain Sickness? |
defined as the presence of headache in an unacclimatized person who has recently arrived at an altitude of 2500 m (8202 ft), plus the presence of one or more of the following: GI symptoms (anorexia, nausea, or vomiting), insomnia, dizziness, lassitude, or fatigue |
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What is Tx of choice for Acute Mountain Sickness? |
Descent; O2 |
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What is recommended initial medical therapy for Acute Mountain Sickness? |
Acetazolamide |
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What is affective in lowering severity of Acute Mountain Sickness? |
dexamethasone |
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What are best ways to prevent Acute Mountain Sickness? |
Gradual ascent; allowing time for acclimatization |
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What are characteristics of Acute Mountain Sickness? |
relative hypoventilation, impaired gas exchange, increased sympathetic activity, fluid retention and redistribution, and in moderate to severe AMS, raised intracranial pressure |
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Patients with which diseases should be counseled on AMS? |
obstructive sleep apnea, chronic obstructive pulmonary disease (COPD), asthma, pulmonary hypertension, thromboembolic disease, and others should be screened and counseled about travel to high-altitude destinations prior to travel |
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DDX for AMS? |
Acute psychosis Anxiety Diabetic ketoacidosis Dehydration Hangover Hypoglycemia Hyponatremia Hypothermia Ingestion of drugs, toxins, and alcohol Neoplasms, brain Stroke Toxicity, carbon monoxide Transient ischemic attack |
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What is the cardinal symptom of AMS? |
headache (6-12 hours after ascent) |
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Acetazolamide should be avoided in: |
hepatic disease pregnancy sulfa allergy |
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Alternative to acetazolamide in those with liver/kidney disease: |
dexamethasone |
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Dexamethasone should be avoided in: |
pregnant GI/Peptic ulcer
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Side effect of dexamethasone if abruptly discontinued: |
depression |
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What is the severe side of AMS? |
1. HACE, which requires hospitalization. HACE is defined as symptoms of AMS plus gait ataxia or mental status changes. HACE may also be defined as gait ataxia and mental status changes regardless of AMS symptoms 2. HAPE is diagnosed in patients with at least 2 of the following signs and symptoms: dyspnea at rest, cough, weakness, decreased exercise performance, chest tightness or congestion and crackles, wheezing, central cyanosis, tachypnea, or tachycardia. |
