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Erie College of Medicine - Weekly SGA Newsletter
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Week of November 4th, 2019
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SGA Monthly Business Meeting
Monday November 11th, 2019
Dinner: 5:30 pm
Meeting: 5:45 pm
LOCATION: Vora Student Lounge
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All students are invited. The following are REQUIRED to attend:
1. Class of 2022 Class Officers
2. Class of 2023 Class Officers
3. All Club Presidents
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If the Student Club President is unable to attend, someone from the club's executive board must attend. If you are required to attend the SGA Meeting and cannot attend, please contact Myriah Magaris (med.secretary@sga.lecom.edu). Please include the reason for your absence.
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Members who paid dues will be able to pick up their T-shirt for Radiology club upon request approval and order placement through a local ERIE company.
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The Family Medicine Club is having another pin sale. We have pins to celebrate the completion of Anatomy (MS1/2) & the GI & Cardiology Systems (MS2)!
$5 each a piece!
Come get one before they run out.
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SOMA and Mentoring Club event to provide Christmas gifts to children at Erie Heights and residents at the Senior Living Center and other LECOM senior facilities
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Come support Special Olympics-Erie by participating in LECOM Sports Med & LECOM Allies's Spikes for Tikes Volleyball Tournament! The cost will be $30 per team (maximum of 12, minimum of 6 per team). Hope to see you there!
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Wellness
Mind | Body | Spirit
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All of you have immense demands on you academic plate and things here definitely move at a breakneck pace. I know I could not conceptualize this until I was here and seeing it. I know there is not a lot (ok…almost no) unused space in your daily schedule. I know that I preach self-care, but also know the reality that …
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A 19-year-old man comes to the university clinic because of nausea and fatigue since moving into his new dorm yesterday. He has been a bit nervous about beginning his first semester of college in Colorado, and finds himself missing his home on the West coast. He has had occasional difficulty breathing that is worse when arranging his furniture in the dorm. He recalls having a nosebleed this morning but was able to stop the bleeding with gentle pressure. He had to walk to the clinic this morning and mentions that he is having trouble catching his breath. He is a healthy, well developed man with no history of anxiety or depression. He denies any alcohol, tobacco, or illicit drug use. He does not take any medication and has been looking forward to visiting the mountains tomorrow before classes begin. The patient appears stable. The lungs are clear to auscultation bilaterally. Results of laboratory studies are pending.
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Which of the following is most likely to be found in this patient?
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A. Decreased PaCO2
B. Decreased ventilation
C. Increased BPG (biphosphoglyerate)
D. Increased PaO2
E. Increased blood Hb
F. Increased renal excretion of HCO3-
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Answer:
A. Decreased PaCO2
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This patient presents with nausea, fatigue, and dyspnea, symptoms that are fairly non-specific and require further investigation. He has traveled from the West coast to Colorado, an area of high altitude, in the last 24 hours. This patient is likely suffering from acute altitude sickness. Symptoms are typically non-specific and can include fatigue, headache, nausea, vomiting, dyspnea, lightheadedness, and insomnia. The onset occurs within the first 24 to 48 hours of traveling to an area of high altitude and usually resolves by day 3 with supportive therapy. In a severe case of altitude sickness, acetazolamide can be used to induce metabolic acidosis to relieve the symptoms.
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The mechanism of altitude sickness begins when a person is exposed to a decreased atmospheric oxygen pressure. This causes a decreased PaO2 inspired by the lungs which is perceived as hypoxia by the body. The body attempts to compensate by increasing the ventilation to increase PaO2. However, increasing ventilation causes more CO2 to be blown off from the blood, decreasing the blood HCO3-, and increasing the pH. Respiratory alkalosis is defined by an increase in blood pH with a decrease in PaCO2(less than 35 mmHg).
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The body compensates for the respiratory alkalosis by inducing metabolic acidosis. The kidney decreases the reabsorption of HCO3- in an attempt to normalize blood pH, however this process takes approximately 48 hours to completely compensate. Over time in an area of high altitude, the body produces 2-3-diphosphoglycerate (DPG), which decreases the affinity of hemoglobin to bind oxygen. As a result, oxygen is more easily unloaded to the tissues allowing appropriate oxygenation. Erythropoietin is produced by the kidney to increase red blood cells and hemoglobin production to increase the total carrying capacity of blood.
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Increased hemoglobin, increased biphosphoglyerate, and increased renal HCO3- excretion are chronic compensatory mechanisms that occur when a person is exposed to decreased atmospheric oxygen (high altitude), but this patient has acute symptoms. Ventilation is increased, not decreased, in response to decreased atmospheric oxygen to compensate for the hypoxia. PaO2 is decreased, not increased, in exposure to high altitude due to decreased atmospheric pressure.
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Dr. Melanie Dunbar, LECOM Director of Behavioral Health
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Crime Victim Center of Erie County
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Drug and Alcohol Services
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Stairways Behavioral Health Gage House
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Copyright © 2019 LECOM Student Government Association, All rights reserved.
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