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Febrile Neutropenia — RACP Adult Medicine MCQ

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ModerateHaematologyFebrile NeutropeniaRACP Adult Medicine

A 55-year-old man receiving chemotherapy for acute leukaemia presents 48 hours post-cycle with fever (39.5°C). Neutrophil count is 0.2 × 10⁹/L. He has a Hickman line in situ. BP is 100/60 mmHg. What is the most appropriate immediate management?

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Correct answer: C — IV dexamethasone 16 mg stat then 4 mg QID

This question's options are constrained. The clinical scenario is febrile neutropenia — an oncological emergency requiring immediate IV broad-spectrum antibiotics (piperacillin-tazobactam per eTG) and blood cultures. Among the available options, none directly lists antibiotics. In practice, the correct answer is empirical antibiotics. Dexamethasone is not the primary intervention here. [Note: this stem tests recognition of febrile neutropenia as an emergency]

Reference: eTG Antibiotic – 2025 – Febrile Neutropenia; eviQ 2024