KIN 3304 1nd Edition Lecture 30 Outline of Last Lecture I Why Asthma Makes it Hard to Breath II What is Asthma III The Plugged Garden Hose Analogy IV Asthma Related Symptoms V Asthma Statistics VI Causes of Asthma VII Triggers include VIII The Hygiene Hypothesis IX The Couch Potato Hypothesis X Hallmarks of Asthma Pathogenesis XI The Asthmatic Lung XII Asthma A Two phase Inflammatory Trigger Response XIII What are the cell types implicated in the phases of asthma XIV Role of Mast Cells and IgE in Asthma XV Association of Atropy with Asthma XVI T helper cells Th1 Th2 XVII Asthma Susceptible Genes XVIII FEV1 FVC Measurements in Asthma Lung These notes represent a detailed interpretation of the professor s lecture GradeBuddy is best used as a supplement to your own notes not as a substitute XIX Therapeutic Side Effects Outline of Current Lecture I What is High Altitude II Why Can t We Breath III Getting Up There IV Why is Going Up a Mountain and coming down so Dangerous V What Challenges Do We See VI Possible TQ VII Acute Mountain Sickness VIII Another Possible TQ IX High Altitude Cerebral Edema X HACE continued Current Lecture I What is High Altitude a High Altitude 5 000 8 000 b Very High Altitude 11 500 18 000 c Extreme Altitude 18 000 30 000 II Why Can t We Breath a There is less partial pressure not less O2 III Getting Up There a You are in a 70 degrees hurricane b In a picture what see surrounding it is jet stream IV Why is Going Up a Mountain and coming down so Dangerous a Acute Mountain Sickness AMS b High Altitude Cerebral Edema HACE c High Altitude Pulmonary Edema HAPE d Other stuff frostbite avalanche falls storms V What Challenges Do We See a Location b Political c Cost VI Possible TQ a Physiologically why are you more likely to die going down a mountain than going up the mountain VII Acute Mountain Sickness a Caused by decreased air pressure and O2 i Faster ascent increased AMS b c less time to adjust 1 Increased risk if you live at lower elevation 2 Increased risk if you ve had AMS before b Symptoms i Poor sleep dizzy fatigue 1 Decreased appetite 2 Shortness of breath 3 Increased HR b c need more O2 to brain body c More Severe AMS i Cyanosis people turn blue ii Cough up blood vessels burst in lungs iii Confusion iv Non ambulatory can t walk right d Treatment i Descend ii Supplementary O2 1 Ventilator sometimes necessary iii Drugs 1 Sildenafil phosphodiesterase inhibitor a Increases blood flow to lungs 2 Beta Agonist a Opens airways b Diamox drug i Helps with breathing ii Increases urination e Prognosis i Mild cases most are mild 1 Should be okay following descent 2 Severe cases death is possible HACE HAPE ii Caveat most high altitude areas are very remote 1 Hospital care unlikely iii Who will help you 1 Climbers wont turn back to help f Prevention i Ascend slowly 1 In high altitude climbing its unlikely to do so ii Frequent Stops 1 Rest 1 2 days every 600m 2 000 ft iii Supplemental O2 above 3000m 10 000 ft iv Eat drink water 1 Hard to do without appetite VIII Another Possible TQ a You re suffering from moderately severe frostbite in your fingers with 3 days of climbing to go Why is it better to keep them frozen i B c as soon as you thaw them out they ll freeze again IX High Altitude Cerebral Edema HACE a Usually 2nd degree to AMS i Climb K2 you will probably already have AMS b Disturbances in consciousness c Can progress rapidly i Psychiatric changes gait changes confusion coma d Rare but high morbidity some mortality e Things he said about HACE i At high altitude you leak fluid ii Gets depositioned in brain cavity iii Swells constricts wont get O2 iv Brain dies f Can occur as low as 200m i Most common in abrupt ascent above 3000m g Can occur in well acclimated climbers above 2000m h More likely in those with HAPE studies i Frequent Alps 13 of patients with HAPE had stupor coma ii Rockies 1 in 7 with HAPE had HACE X HACE continued a Development i AMS to HACE usually takes 24 36 hours ii As little as a few hours at extreme altitude b Presentation i Change in consciousness gait 1 Progressive AMS over 24 48 hours ii Usually not always with headache iii Drowsiness appears iv Victim withdrawn apathetic v Inability to care for oneself vi Confusion 1 Stripping off clothes vii Anorexia almost always nausea coma viii If patient seems mildly drunk at altitude c Treatment i If coma develops they re going to die ii Similar to AMS get them down 1 O2 hyperbaric bag 2 Large steroid dose dexamethasome 3 Severe cases decrease intracranial pressure iii Hospitalization ASAP 1 4 5 days is common
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