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Acute respiratory distress syndrome — SCE Acute Medicine MCQ

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ModerateAcute Respiratory PresentationsAcute respiratory distress syndromeSCE Acute Medicine

A 58-year-old man presents with acute breathlessness with chest symptoms. Relevant history includes respiratory disease and a relevant acute precipitant. On assessment, respiratory distress is present with abnormal oxygenation. Investigations show severe hypoxaemia and bilateral infiltrates follow pancreatitis with normal LV function. What is the most likely diagnosis?

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Correct answer: A — Acute respiratory distress syndrome

The key discriminator is that severe hypoxaemia and bilateral infiltrates follow pancreatitis with normal LV function, which makes Acute respiratory distress syndrome the single best answer. Vasculitic pulmonary-renal syndrome is less appropriate because it does not address the dominant acute risk in the vignette; Pulmonary embolism would fit a different presentation or later stage of care. Bacterial meningitis and Acute kidney injury 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: https://www.nice.org.uk/guidance#acute-medicine-order-23-1