skip to main content

Sickle cell acute chest syndrome — SCE Acute Medicine MCQ

Instant feedback + full explanation. One question, done properly.

ModerateHaematological EmergenciesSickle cell acute chest syndromeSCE Acute Medicine

A 34-year-old woman presents with fever, bleeding, thrombosis or severe anaemia. Relevant history includes malignancy, chemotherapy, haemoglobinopathy or anticoagulant exposure. On assessment, blood film and coagulation results are abnormal. Investigations show new infiltrate, fever, chest pain and hypoxaemia in sickle cell disease. What is the most appropriate next step in management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Give oxygen, antibiotics, analgesia and discuss transfusion

The key discriminator is that new infiltrate, fever, chest pain and hypoxaemia in sickle cell disease, which makes Give oxygen, antibiotics, analgesia and discuss transfusion the single best answer. Arrange urgent CT imaging is less appropriate because it does not address the dominant acute risk in the vignette; Call critical care for escalation would fit a different presentation or later stage of care. Optimise chronic medication and discharge and Start anticoagulation after assessing bleeding risk are suboptimal because they would either delay time-critical treatment or follow the wrong acute pathway. Teaching point: SCE-style acute medicine questions usually test prioritisation using physiology, timing and a guideline-defined threshold, rather than isolated factual recall.

Reference: BSH sickle cell acute chest guideline