American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the primary treatment for high-altitude pulmonary edema?

1. Administering corticosteroids

2. Providing supplemental oxygen and considering descent

3. Using diuretics immediately

4. Implementing bronchial dilation therapy

The correct answer is: Providing supplemental oxygen and considering descent

Providing supplemental oxygen and considering descent is the primary treatment for high-altitude pulmonary edema (HAPE) because these strategies directly address the underlying hypoxia caused by reduced atmospheric pressure at high altitudes. HAPE occurs when fluid accumulates in the lungs, leading to impaired gas exchange and decreased oxygenation. Supplemental oxygen delivery improves oxygenation, mitigating the effects of the hypoxic environment. This can help alleviate symptoms such as difficulty breathing and fatigue that arise from decreased oxygen levels in the blood. Additionally, descending to a lower altitude is crucial as it reduces exposure to the high-altitude environment, allowing for natural resolution of the condition. Descending can rapidly improve symptoms and prevent further complications, making it a critical component of effective management. Other interventions, while they may provide some benefit in specific contexts, do not directly target both the hypoxic environment and fluid accumulation in the way that supplemental oxygen and descent do. For instance, corticosteroids might help reduce inflammation but are not the primary approach for HAPE. Diuretics can assist in managing fluid overload but do not address the main issue of altitude-related hypoxia. Bronchial dilation therapy is not standard treatment for HAPE. Thus, the combined approach of providing supplemental oxygen and considering descent effectively targets