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High-altitude pulmonary oedema — DipIMC MCQ

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HardEnvironmental MedicineHigh-altitude pulmonary oedemaDipIMC

A climber at 3,500 metres has severe breathlessness, cough productive of frothy sputum and crackles. He is anxious and cyanosed. What is the most appropriate drug/dose?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Oxygen if available with urgent descent and evacuation

High-altitude pulmonary oedema is treated with descent, oxygen and evacuation, with adjunctive medications depending on protocols and availability. Entonox is inappropriate in hypoxaemic altitude illness and can worsen gas expansion issues in other contexts. Continuing ascent is dangerous. The pearl is that descent is the definitive treatment for severe altitude illness.

Reference: JRCALC Guidelines 2025; UIAA/UK altitude illness guidance