High-altitude pulmonary oedema — MCCQE Part 1 MCQ

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ModerateShortness of BreathHigh-altitude pulmonary oedemaMCCQE Part 1

A 28-year-old climber in the Rockies develops dyspnoea at rest, cough, crackles and oxygen saturation 78% after rapid ascent. Which of the following is the most appropriate next step?

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Correct answer: A — Administer oxygen and descend immediately if possible

Administer oxygen and descend immediately if possible is the single best answer because the age, timing, examination findings and investigations in the vignette fit High-altitude pulmonary oedema better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to Wilderness Medical Society and Canadian travel medicine guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: Wilderness Medical Society and Canadian travel medicine guidance