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Acute exacerbation of idiopathic pulmonary fibrosis — SCE Acute Medicine MCQ

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ModerateAcute Respiratory PresentationsAcute exacerbation of idiopathic pulmonary fibrosisSCE Acute Medicine

A 76-year-old woman 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 new bilateral ground-glass change on fibrotic background after PE exclusion. What is the most likely diagnosis?

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Correct answer: C — Acute exacerbation of idiopathic pulmonary fibrosis

The key discriminator is that new bilateral ground-glass change on fibrotic background after PE exclusion, which makes Acute exacerbation of idiopathic pulmonary fibrosis the single best answer. Acute pancreatitis is less appropriate because it does not address the dominant acute risk in the vignette; Acute kidney injury would fit a different presentation or later stage of care. Septic shock and Anaphylaxis 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: NICE IPF guidance; BTS ILD statements