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Severe CAP — MRCEM SBA MCQ

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HardRespiratory MedicineSevere CAPMRCEM SBAMRCP Part 1UKMLAPARA

A patient with community-acquired pneumonia has CURB65 score 3 but appears temporarily stable after initial oxygen. What site-of-care principle applies?

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Correct answer: D — Admit urgently and assess critical-care needs

The best answer is “Admit urgently and assess critical-care needs”. A CURB65 score of 3 or more indicates high mortality risk and requires urgent hospital management with assessment for critical-care involvement, while clinical physiology can further increase risk. Temporary improvement with oxygen does not make outpatient care safe. Antibiotics and resuscitation should not await microbiology.

Reference: NICE: Pneumonia in adults—diagnosis and management (NG138): https://www.nice.org.uk/guidance/ng138