skip to main content

Pleural aspiration safety — SCE Acute Medicine MCQ

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

ModerateProcedural Knowledge in Acute MedicinePleural aspiration safetySCE Acute Medicine

A 71-year-old woman presents with a procedure-related acute decision. Relevant history includes coagulation, imaging, respiratory physiology or procedural risk. On assessment, bedside findings determine whether the procedure is safe and urgent. Investigations show large effusion with ultrasound-identified safe pocket. 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: E — Perform ultrasound-guided diagnostic aspiration with local safety checks

The key discriminator is that large effusion with ultrasound-identified safe pocket, which makes Perform ultrasound-guided diagnostic aspiration with local safety checks the single best answer. Give controlled oxygen and senior review is less appropriate because it does not address the dominant acute risk in the vignette; Give intravenous fluids with reassessment would fit a different presentation or later stage of care. Give targeted antidote or reversal therapy and Give analgesia and antiemetic 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: BTS Pleural Procedures Statement