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DRESS syndrome — SCE Acute Medicine MCQ

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EasyAcute Rheumatological and Dermatological EmergenciesDRESS syndromeSCE Acute Medicine

A 55-year-old man presents with rash, allergic features, visual symptoms or systemic inflammation. Relevant history includes recent drug exposure, autoimmune disease or allergen exposure. On assessment, skin, mucosal or vascular findings suggest systemic disease. Investigations show delayed rash, facial oedema, eosinophilia and hepatitis after carbamazepine. What is the most likely diagnosis?

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Correct answer: C — Drug reaction with eosinophilia and systemic symptoms

The key discriminator is that delayed rash, facial oedema, eosinophilia and hepatitis after carbamazepine, which makes Drug reaction with eosinophilia and systemic symptoms the single best answer. Diabetic ketoacidosis is less appropriate because it does not address the dominant acute risk in the vignette; Toxic drug ingestion would fit a different presentation or later stage of care. Acute pancreatitis and Acute coronary syndrome 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: BAD drug eruption guidance; BNF