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KIN 424 - Medical Aspects of Sport > Module 6 - Athletes at High Altitude: Medical Aspects > Flashcards

Module 6 - Athletes at High Altitude: Medical Aspects Flashcards

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1
Q

What is the Himalayan Rescue Association?

A
  • Non-profit Nepali Run Organization
  • Mandate to reduce illness & mortality in the Himalayas
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2
Q

What does the Himalayan Rescue Association do?

A
  • Educate: Foreigners and Nepalese
  • Medical Care for Travellers
  • Medical Care for Locals (subsidized by foreigners)
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3
Q

Where is the Himalayan Rescue Association Located?

A
  • 3 Permanent Clinics in Nepal
  • 1 Emergency Clinic: Lake Gosainkunda (LangTang Region)
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4
Q

What does the Manang Aid Post in Nepal do?

A
  • Operate an aid post
  • Daily lecture to trekkers and guides
  • House calls to villagers and nearby monasteries
  • Organise Evacuations when Necessary
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5
Q

How many Staff does the Manang Aid Post in Nepal have?

A
  • 3 Physicians
  • 1 RN
  • 1 Cook
  • 1 Chef de Maison
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6
Q

How does altitude acclimatization work?

A

Increased
- Ventilation
- Cardiac Output
- Hemoconcentration

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7
Q

What does Altitude Acclimatization do?

A
  • enhances Oxygen Delivery
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8
Q

What is the best way to undergo altitude acclimatization?

A

Occurs over days to months
- Graded ascent where possible

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9
Q

How long before sleep improvements are seen in altitude acclimatization?

A
  • First few days
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10
Q

What happens after weeks to months of altitude acclimatization?

A
  • Red Blood Cell mass increases
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11
Q

What are the Altitude Illness Syndromes?

A
  • Acute Mountain Sickness (AMS)
  • High Altitude Cerebral Oedema (HACE)
  • High Altitude Pulmonary Oedema (HAPE)
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12
Q

What are the confirmed risk factors for Acute Mountain Sickness?

A
  • Rate of Ascent
  • Previous History of AMS
  • Exertion
  • Obesity
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13
Q

What are some unconfirmed but possible risk factors for Acute Mountain Sickness?

A
  • Previous Neck Dissection
  • Dehydration
  • Infection
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14
Q

What are the symptoms of Acute Mountain Sickness?

A
  • Headache
  • Sleep Disturbance, Insomnia
  • Anorexia, Nausea, Vomiting
  • Light-headedness, dizziness
  • Fatigue
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15
Q

What are some other possible explanations for symptoms of Acute Mountain Sickness?

A
  • Dehydration
  • Hangover
  • Migraine
  • Overexertion
  • Viral Illness
  • Subarachnoid Haemorrhage
  • Carbon Monoxide Exposure
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16
Q

What is High-Altitude Cerebral Oedema?

A
  • Believed to be the severe end of the AMS spectrum
  • Can be lethal within 12 hours
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17
Q

What are the symptoms of High-Altitude Cerebral Oedema?

A

AMS Symptoms Plus:
- Ataxia
- Confusion
- Lethargy
- Altered level of consciousness

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18
Q

What is High-Altitude Pulmonary Oedema?

A
  • Most lethal altitude illness
  • Separate Condition from AMS/HACE: often co-exist
  • Onset after 2-5 days
  • Aggravated by cold, exertion
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19
Q

What are the risk factors of High-altitude Pulmonary Oedema (HAPE)?

A
  • Rate of Ascent
  • Exertion
  • Previous History
  • Primary Pulmonary Hypertension
  • Unilateral Pulmonary Artery
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20
Q

What are the Symptoms of High-Altitude Pulmonary Oedema (HAPE)?

A
  • Dyspnoea at Rest
  • Cough
  • Bloody Cough: Pink Frothy Sputum
  • Poor Exercise Tolerance
  • Orthopnoea
  • Febrile (fever)
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21
Q

What is the problem with medications for Altitude Illness Prevention?

A
  • Most medications are not Permitted by WADA
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22
Q

What medications for altitude illness prevention are not permitted by WADA?

A
  • Acetazolamide
  • Dexamethasone
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23
Q

What medications are used for AMS and HACE?

A
  • ACetazolamide
  • Dexamethasone
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24
Q

What medications for altitude illness are permitted?

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A
  • Tadalafil (Cialis): previously monitored
  • Nifedipine
25
What medications are used to prevent High-Altitude Pulmonary Oedema?
- Tadalafil (Cialis) - Nifedipine
26
What level of activity should you perform during the first few days of altitude acclimatization?
- Decreased Intensity
26
What level of activity should you perform during the first few days of altitude acclimatization?
- Decreased Intensity
27
What is the hydration and nutrition recommendation for activity at high altitudes?
- Maintain hydration: dehydration prone - High CHO diet
28
What does previous history determine about altitude illness?
- Important for rare conditions: HAPE and probably HACE - Not as helpful for AMS
29
What is the treatment for altitude illness?
Permitted - Descent - Oxygen Not Permitted - Most medications
30
What is a Gamow Bag?
- Inflates to 2 psi - Simulated descent - Equivalent to 1600 metre descent - Temporizing measure
31
How does Ultraviolet Radiation play into high-altitude activity?
Increased - intensity - potential for burns - potential for snow blindness - reflection off snow or water
32
How does high altitude impact the immune system?
Immunosuppression - Susceptibility to infection
33
What is the recommendation for the immune system when ascending to high altitudes?
- Stay up to date on immunizations
34
How can having Refractive Eye Surgery impact your experience at high altitudes?
- Transient blurring due to drying and corneal edema - Resolves on Descent
35
What are the recommendations for someone who has had refractive eye surgery when ascending to high altitudes?
- Artificial tears - Full goggles may help
36
How is Asthma impacted by high-altitude activity?
- Not clinically worse
37
What are the recommendations for someone with Asthma when ascending to high altitude?
- have a medication supply - monitor temperature
38
How does high-altitude activity impact those with Coronary Artery Disease?
- No increased incidence
39
What is important to know about children when they ascend to high altitudes?
- History may be difficult to know
40
How are people with sickle cell trait impacted by high altitudes?
Heterozygous Hbs - At risk for splenic infarctions
41
At what height do athletes experience altitude illness?
- typically above 2500m (8000')
42
At what height do athletes usually do destination altitude training?
- typically 1800-2500m
43
How does intense exercise at high altitudes change the picture?
- AMS reported at 1950 - 2100m in athletes at training camps - Incidence up to 44%
44
What is recommended for training at high altitudes?
- Lower intensity on the first few days
45
What is common with endurance athletes regarding iron?
- Low iron stores
46
Why do endurance athletes have low iron stores?
- Increased red cell destruction - Sweat loss of iron - Impaired iron absorption post-exercise
47
What is iron necessary for?
- Red Cell Synthesis
48
What is the recommended protocol for iron management at high altitudes for endurance athletes?
- Test and treat early - Treatment: for specific iron deficient non-anaemia groups
49
What does Hypoxia do to sleep?
- Directly Impares
50
Why does Hypoxia impact sleep?
- More Frequent arousals - Less restful - impacting recovery
51
Why is sleep impacted at high-altitude training?
- Hypoxia - Jet lag - Poor sleep environment
52
What are the recommendations for improving sleep at high altitudes?
- Quiet, dark, comfortable temperature environment - Caffeine, alcohol and nicotine interfere with sleep - Exercise in the late afternoon/early evening - Light Bedtime snack - Electronics and device interfere with sleep - Aggressive management of jet lag
53
What are the recommendations for using sleep medications at high altitudes?
- Consider carefully: adverse effects - Consult with a physician - Safe at altitude
54
What sleep medications are permitted?
- Temazepam - Zolpidem - Zaleplon
55
What sleep medication is prohibited?
- Acetazolamide
56
What are some altitude pre-acclimatization strategies?
- Intermittent hypoxia training: tents and camps - Avoid illness, dehydration, and sleep debt on arrival
57
What does prolong

KIN 424 - Medical Aspects of Sport (11 decks)

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