Cardiovascular: acetazolamide for altitude sickness: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pharmacology · Cardiovascular: acetazolamide for altitude sickness

Sample item

A trekker ascending quickly to high altitude wishes to prevent acute mountain sickness. Which drug is recommended and what is its mechanism?

AFurosemide, which causes hypocalcaemiaBMannitol, which draws water from the brain permanentlyCSpironolactone, which retains potassiumDAcetazolamide, which causes bicarbonate diuresis and a mild metabolic acidosis that stimulates breathing

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Acetazolamide, which causes bicarbonate diuresis and a mild metabolic acidosis that stimulates breathing

Acetazolamide inhibits carbonic anhydrase, producing metabolic acidosis that increases ventilatory drive and speeds acclimatisation. Dexamethasone is an alternative for treatment. Paraesthesias and altered taste are common side effects.

Option by option

A. Furosemide, which causes hypocalcaemia
Furosemide is not used for prevention.
B. Mannitol, which draws water from the brain permanently
Mannitol is not used for prophylaxis.
C. Spironolactone, which retains potassium
Spironolactone has no role.
D. Acetazolamide, which causes bicarbonate diuresis and a mild metabolic acidosis that stimulates breathing (correct)
Correct. Induced acidosis stimulates ventilation.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is D, Acetazolamide, which causes bicarbonate diuresis and a mild metabolic acidosis that stimulates breathing. Acetazolamide inhibits carbonic anhydrase, producing metabolic acidosis that increases ventilatory drive and speeds acclimatisation.

Why is "Furosemide, which causes hypocalcaemia" not the answer?

Furosemide is not used for prevention.

Why is "Mannitol, which draws water from the brain permanently" not the answer?

Mannitol is not used for prophylaxis.

Why is "Spironolactone, which retains potassium" not the answer?

Spironolactone has no role.

What concept does this question test?

It tests Cardiovascular: acetazolamide for altitude sickness in Pharmacology. Dexamethasone is an alternative for treatment. Paraesthesias and altered taste are common side effects.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Cardiovascular: acetazolamide for altitude sickness?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.