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Meningococcal septicaemia — SCE Acute Medicine MCQ

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EasySepsis and Infectious EmergenciesMeningococcal septicaemiaSCE Acute Medicine

A 71-year-old man 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 purpuric non-blanching rash with shock and coagulopathy. What is the most important immediate action?

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Correct answer: E — Give immediate intravenous ceftriaxone and sepsis resuscitation

The key discriminator is that purpuric non-blanching rash with shock and coagulopathy, which makes Give immediate intravenous ceftriaxone and sepsis resuscitation the single best answer. Activate the major haemorrhage protocol is less appropriate because it does not address the dominant acute risk in the vignette; Call for urgent surgical source control would fit a different presentation or later stage of care. Give broad-spectrum intravenous antibiotics within one hour and Start acetylcysteine without delay 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 NG240; NICE NG253