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Neutropenic sepsis — SCE Acute Medicine MCQ

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HardSepsis and Infectious EmergenciesNeutropenic sepsisSCE Acute Medicine

A 45-year-old woman 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 fever with neutrophils 0.2 after chemotherapy. What is the most important immediate action?

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Correct answer: C — Give empirical broad-spectrum intravenous antibiotic within one hour

The key discriminator is that fever with neutrophils 0.2 after chemotherapy, which makes Give empirical broad-spectrum intravenous antibiotic within one hour the single best answer. Give broad-spectrum intravenous antibiotics within one hour is less appropriate because it does not address the dominant acute risk in the vignette; Protect the airway and support ventilation would fit a different presentation or later stage of care. Give hypertonic saline bolus and Perform immediate decompression 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 CG151