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Severe pneumonia with sepsis — SCE Acute Medicine MCQ

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ModerateSepsis and Infectious EmergenciesSevere pneumonia with sepsisSCE Acute Medicine

A 34-year-old woman presents with fever, systemic upset and acute deterioration. Relevant history includes a plausible infectious exposure or immunocompromising context. On assessment, NEWS2 is elevated and there are features of organ dysfunction. Investigations show multilobar consolidation, hypoxaemia, hypotension and high lactate. What is the most appropriate next step in management?

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Correct answer: C — Give oxygen, intravenous antibiotics and fluids with senior review

The key discriminator is that multilobar consolidation, hypoxaemia, hypotension and high lactate, which makes Give oxygen, intravenous antibiotics and fluids with senior review the single best answer. Call critical care for escalation is less appropriate because it does not address the dominant acute risk in the vignette; Give controlled oxygen and senior review would fit a different presentation or later stage of care. Give intravenous fluids with reassessment and Give targeted antidote or reversal therapy 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 NG250; NICE NG253