What is the likely diagnosis for a college student who develops nausea, vomiting, and dyspnea (difficulty breathing) after arriving in Denver from Miami and engaging in strenuous physical activity at high altitude?

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Differential Diagnosis for Marcus

  • Single most likely diagnosis
    • d. mountain sickness: This is the most likely diagnosis given Marcus's symptoms of nausea, vomiting, and shortness of breath after traveling to a high-altitude location (Denver) and engaging in strenuous physical activity (skiing). Mountain sickness, also known as acute mountain sickness (AMS), is a common condition that occurs when the body cannot adapt to high altitudes, leading to a range of symptoms.
  • Other Likely diagnoses
    • e. asthma: Although Marcus's symptoms are more suggestive of mountain sickness, asthma is a possible diagnosis, especially if he has a pre-existing condition. The high-altitude environment and physical exertion could trigger an asthma attack, leading to shortness of breath and nausea.
    • a. pneumonia: While less likely, pneumonia is a possible diagnosis, especially if Marcus has been exposed to someone with a respiratory infection. However, the acute onset of symptoms after arriving in Denver and engaging in physical activity makes this diagnosis less likely.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • High-altitude pulmonary edema (HAPE): Although not listed as an option, HAPE is a life-threatening condition that can occur at high altitudes. It is characterized by fluid buildup in the lungs, leading to severe shortness of breath, cough, and fatigue. While rare, HAPE can be deadly if not recognized and treated promptly.
    • High-altitude cerebral edema (HACE): Another potentially life-threatening condition, HACE occurs when fluid builds up in the brain, leading to severe headache, confusion, and loss of coordination. Like HAPE, HACE is rare but requires immediate medical attention.
  • Rare diagnoses
    • b. pneumoconiosis: This is a rare diagnosis, as pneumoconiosis is a lung disease caused by inhaling dust particles, typically occurring in individuals with prolonged exposure to hazardous materials (e.g., miners). Marcus's symptoms and history do not suggest pneumoconiosis as a likely diagnosis.
    • c. chronic bronchitis: While chronic bronchitis is a possible diagnosis, it is less likely given Marcus's acute symptoms and the context of his recent travel to a high-altitude location. Chronic bronchitis is a chronic condition characterized by persistent cough and mucus production, which does not fit with Marcus's presentation.

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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