FAA Private Pilot Airplane (PAR)Aeromedical Factors and ADMHard

During a post-flight inspection, a mechanic discovers that the exhaust manifold on a pilot's aircraft has a small crack, allowing exhaust gases to leak into the cabin heating system. On a recent flight, the pilot reported a headache and mild confusion but no vision changes or cyanosis. This scenario is most consistent with which type of hypoxia, caused by exposure to carbon monoxide?

  1. AHypoxic hypoxia
  2. BHypemic hypoxia
  3. CStagnant hypoxia
  4. DHistotoxic hypoxia
Show answer & explanation

Correct answer: B. Hypemic hypoxia

Carbon monoxide binds to hemoglobin far more readily than oxygen, reducing the blood's oxygen-carrying capacity; this is classified as hypemic hypoxia, and symptoms include headache and confusion, often without the cyanosis seen in hypoxic hypoxia.

Why the other options are wrong

  • A. Hypoxic hypoxia is caused by reduced ambient oxygen pressure at altitude, not by CO displacing oxygen in the blood.
  • C. Stagnant hypoxia is caused by poor blood circulation, such as from shock, not from a chemical binding issue.
  • D. Histotoxic hypoxia occurs when tissues cannot utilize oxygen properly, typically from alcohol or certain drugs, not from CO binding hemoglobin.

Hypemic Hypoxia (CO Poisoning)

A form of hypoxia caused by a reduction in the blood's ability to carry oxygen, commonly due to carbon monoxide binding to hemoglobin far more strongly than oxygen.

  • CO binds hemoglobin ~200x more readily than oxygen
  • Symptoms: headache, confusion, drowsiness
  • Cabin heat exchangers cracked near exhaust are a common source

Memory trick: CO steals hemoglobin's seat from oxygen

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