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Aspiration pneumonitis — SCE Acute Medicine MCQ

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ModerateAcute Respiratory PresentationsAspiration pneumonitisSCE Acute Medicine

A 42-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 hypoxia occurs immediately after witnessed aspiration with low inflammatory markers. What is the most appropriate next step in management?

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Correct answer: B — Provide supportive care and reassess for evolving infection

The key discriminator is that hypoxia occurs immediately after witnessed aspiration with low inflammatory markers, which makes Provide supportive care and reassess for evolving infection the single best answer. Start anticoagulation after assessing bleeding risk is less appropriate because it does not address the dominant acute risk in the vignette; Give analgesia and antiemetic therapy would fit a different presentation or later stage of care. Arrange routine outpatient follow-up and Call critical care for escalation 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