High-altitude pulmonary oedema — DIPIMC MCQ

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HardEnvironmental MedicineHigh-altitude pulmonary oedemaDIPIMC DipIMC

A climber at 4000 metres is breathless at rest with a cough productive of pink frothy sputum, crackles on auscultation and significant hypoxia.

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Correct answer: A — Arrange descent, give oxygen and nifedipine

Explanation lettering: E = shown as D · D = shown as E

Breathlessness at rest with frothy sputum and hypoxia at altitude indicates high-altitude pulmonary oedema, managed by descent, oxygen and nifedipine. Dexamethasone (B) is the agent for cerebral, not pulmonary, oedema, and further ascent (E) would be harmful. Distinguish HAPE from HACE, but for both the lifesaving action is to lose altitude.

Reference: Wilderness medicine guidance; JRCALC