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Severe community-acquired pneumonia — SCE Acute Medicine MCQ

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EasyAcute Respiratory PresentationsSevere community-acquired pneumoniaSCE Acute Medicine

A 58-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 confusion, hypotension, raised urea and multilobar consolidation indicate high-severity pneumonia. What is the most important immediate action?

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Correct answer: D — Give intravenous antibiotics and sepsis resuscitation

The key discriminator is that confusion, hypotension, raised urea and multilobar consolidation indicate high-severity pneumonia, which makes Give intravenous antibiotics 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. Protect the airway and support ventilation and Give high-flow oxygen 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