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Community-acquired pneumonia — MCCQE Part 1 MCQ

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ModerateCoughCommunity-acquired pneumoniaMCCQE Part 1

A 74-year-old woman with fever, productive cough and pleuritic pain has focal crackles and a right lower-lobe infiltrate. She is confused, respiratory rate is 32/min and blood pressure is 92/58 mmHg. Which of the following is the most appropriate next step?

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Correct answer: D — Admit to hospital for empiric antibiotics and severity-based monitoring

This is community-acquired pneumonia with severity features including confusion, tachypnoea and hypotension, requiring hospital care and empiric antibiotics. Culture results should not delay treatment in a clinically significant pneumonia. Viral bronchitis, inhaled steroid monotherapy and delayed review underestimate the acute risk.

Reference: Canadian community-acquired pneumonia guidance; provincial antimicrobial stewardship resources