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COVID-19 hypoxaemic pneumonitis — SCE Acute Medicine MCQ

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ModerateAcute Respiratory PresentationsCOVID-19 hypoxaemic pneumonitisSCE Acute Medicine

A 34-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 oxygen requirement with bilateral peripheral COVID-19 opacities. What is the most appropriate next step in management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Give oxygen, dexamethasone and thromboprophylaxis

The key discriminator is that oxygen requirement with bilateral peripheral COVID-19 opacities, which makes Give oxygen, dexamethasone and thromboprophylaxis the single best answer. Arrange urgent specialist referral is less appropriate because it does not address the dominant acute risk in the vignette; Provide supportive care and close monitoring would fit a different presentation or later stage of care. Optimise chronic medication and discharge and Arrange urgent CT imaging 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 NG191; BNF