Respiratory medicine: high-altitude pulmonary oedema: practice question

A General Medicine 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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General Medicine · Respiratory medicine: high-altitude pulmonary oedema

Sample item

A 30-year-old trekker ascends quickly to 4,500 m and on day 2 develops dry cough and breathlessness at rest with crackles. SpO2 is 70% and he is afebrile. Apart from descent and oxygen, which drug lowers pulmonary artery pressure in this condition?

AFurosemideBDexamethasoneCMorphineDNifedipine

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

The answer and the reasoning

D. Nifedipine

High-altitude pulmonary oedema is non-cardiogenic oedema caused by uneven hypoxic pulmonary vasoconstriction and a high capillary pressure. Descent and oxygen are the main treatments, and nifedipine lowers pulmonary pressure. Dexamethasone is for cerebral oedema, not this condition.

Option by option

A. Furosemide
Furosemide may worsen volume depletion and is not effective in this condition.
B. Dexamethasone
Dexamethasone treats high-altitude cerebral oedema and acute mountain sickness, not pulmonary oedema.
C. Morphine
Morphine depresses ventilation and is hazardous in hypoxia.
D. Nifedipine (correct)
Correct. Nifedipine relaxes the hypoxic pulmonary vasoconstriction that drives the oedema.

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 General Medicine question

What is the answer to this General Medicine question?

The best answer is D, Nifedipine. High-altitude pulmonary oedema is non-cardiogenic oedema caused by uneven hypoxic pulmonary vasoconstriction and a high capillary pressure.

Why is "Furosemide" not the answer?

Furosemide may worsen volume depletion and is not effective in this condition.

Why is "Dexamethasone" not the answer?

Dexamethasone treats high-altitude cerebral oedema and acute mountain sickness, not pulmonary oedema.

Why is "Morphine" not the answer?

Morphine depresses ventilation and is hazardous in hypoxia.

What concept does this question test?

It tests Respiratory medicine: high-altitude pulmonary oedema in General Medicine. Descent and oxygen are the main treatments, and nifedipine lowers pulmonary pressure. Dexamethasone is for cerebral oedema, not this condition.

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 Respiratory medicine: high-altitude pulmonary oedema?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine 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.