Exercise limitations:

• PAD restricts duration through pain.
• DVT requires avoiding movement until stabilised.

Safety modifications:

• PAD needs rest breaks at pain onset.
• DVT starts with upper body focus only.

Intensity guidelines:

• PAD: moderate (40 – 60% HRmax).
• DVT: very low (20 – 30% HRmax) initially.

Movement adaptations:

• PAD uses walking intervals.
• DVT progresses from seated to standing exercises.

Medical clearance:

• Both require medical approval and monitoring for exercise progression.

Sample Answer

Reduced oxygen carrying capacity effects:

• Iron deficiency reduces hemoglobin concentration, significantly decreasing the blood’s ability to transport oxygen to working muscles during both rest and exercise.

Impact on aerobic energy system:

• The reduced oxygen delivery to muscles forces greater reliance on anaerobic energy systems, leading to earlier onset of fatigue and increased lactate production during exercise.

Increased heart rate at submaximal intensities:

• To compensate for reduced oxygen carrying capacity, the heart rate increases more than normal at any given submaximal workload to maintain adequate oxygen delivery to tissues.

Decreased VO₂ max:

• Maximum oxygen uptake is significantly reduced due to the limited oxygen carrying capacity of the blood, typically decreasing by 10 – 20% depending on the severity of anemia.

Dietary iron supplementation strategy:

• Iron supplementation should be prescribed by a healthcare provider, typically starting with 65 – 100mg of elemental iron daily, preferably in the form of ferrous sulfate.

Timing of iron-rich meals with vitamin C:

• Iron-rich foods (like lean red meat, legumes, and leafy greens) alongside vitamin C sources (citrus fruits, bell peppers) enhances iron absorption by up to 300%.

Training modifications during treatment:

• Exercise intensity and duration should be reduced during initial treatment phases, with a gradual return to normal training loads as hemoglobin levels improve over 4 – 8 weeks.

Sample Answer

Initial responses – Increased ventilation rate and depth:

• The body immediately responds to lower oxygen partial pressure at altitude by increasing breathing rate and depth (hyperventilation) to maximize oxygen uptake in the lungs.

Short-term adaptations – increased heart rate and cardiac output:

• Heart rate increases to compensate for reduced oxygen availability, while cardiac output rises to maintain adequate oxygen delivery to tissues, typically seen within the first 24-48 hours at altitude.

Long-term adaptations – increased EPO production:

• The kidneys detect lower oxygen levels and increase production of erythropoietin (EPO), a hormone that stimulates red blood cell production in the bone marrow.

Increased red blood cell production and hemoglobin concentration:

• Over 3+ weeks, the bone marrow responds to elevated EPO levels by producing more red blood cells, leading to a 10-15% increase in total hemoglobin concentration.

Enhanced oxygen carrying capacity:

• The increased number of red blood cells and hemoglobin molecules significantly improves the blood’s ability to transport oxygen from the lungs to working muscles.

Improved capillarisation in muscle tissue:

• New capillaries develop within muscle tissue to enhance oxygen delivery and removal of waste products, though this adaptation typically takes several weeks to develop fully.

Discussion of oxygen partial pressure effects:

• The reduced partial pressure of oxygen at 2500m (approximately 75% of sea level) triggers these adaptations as the body attempts to maintain adequate tissue oxygenation despite the thinner air.

Consider Option D:  Increased heart rate and decreased oxygen carrying capacity

• Lower haemoglobin leads to reduced oxygen carrying capacity, heart rate increases to compensate

Other Options:

• A is incorrect: Stroke volume isn’t directly affected by iron deficiency
• B is incorrect: Capillarisation is a long-term adaptation
• C is incorrect: Blood pressure typically decreases in anemia

Consider Option B:  Increased breathing rate and depth

• The immediate response to high altitude is hyperventilation to compensate for lower oxygen partial pressure

Other Options:

• A is incorrect: RBC production (erythropoiesis) takes several days to weeks
• C is incorrect: While cardiac output increases, it’s secondary to respiratory changes
• D is incorrect: Capillarisation is a long-term adaptation