MCQ Pediatrics Answer 33

The Correct Answer is D


Acute mountain sickness (AMS) is a clinical syndrome which may affect up to 65% of persons ascending to altitudes greater than 8000 feet. While a standard definition of AMS does not exist, persons having three or more of the following symptoms may be considered to have AMS: headache, nausea, vomiting, sleep disturbance, anorexia, fatigue, or dyspnea.

Gradual ascent is recommended to allow acclimatization. Measures which may help minimize symptoms include avoidance of alcohol, increased fluid intake, and a high-carbohydrate diet.

Acetazolamide (Diamox) speeds the process of acclimatization. The drug is a carbonic anhydrase inhibitor which results in a renal bicarbonate diuresis and subsequent metabolic acidosis, thereby increasing ventilation and arterial oxygenation. The respiratory stimulation is particularly important during sleep, when it reduces the severe hypoxemia caused by periodic breathing. The drug also lowers cerebrospinal fluid volume and pressure, which may play an additional role in its therapeutic and prophylactic utility.


Fluid restriction and diuretics should be avoided because of the diuresis associated with acclimatization, which may by itself case dehydration. Antibiotics are of no benefit. -blockers would be harmful, by interfering with the physiologic responses of tachycardia and increased cardiac output at higher altitudes.


Ref: Tintinalli JE, Kelen GD, Stapczynski JS (eds): Emergency Medicine: A Comprehensive Study Guide, ed 5. McGraw-Hill, 2000, pp 1263-1265. (ABFP 2002)

Category: Pediatrics MCQs