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Acute respiratory distress syndrome — SCE Acute Medicine MCQ

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HardAcute Respiratory PresentationsAcute respiratory distress syndromeSCE Acute Medicine

A 58-year-old woman is assessed on the acute medical unit. She is 48 hours into admission with pancreatitis and now needs 60% oxygen. Chest radiograph shows new bilateral infiltrates and echocardiography shows no evidence of cardiogenic pulmonary oedema. Initial assessment includes relevant observations, bedside tests and urgent blood results. What is the most likely diagnosis?

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Correct answer: A — Acute respiratory distress syndrome

Acute respiratory distress syndrome is the best answer because acute hypoxaemia with bilateral infiltrates after systemic inflammation and no cardiac explanation is most consistent with ARDS. Lung abscess is plausible, but it is less appropriate for the physiology or timing described in this stem. The other distractors either fit a neighbouring presentation, delay definitive treatment, or miss the key immediate risk. Clinical pearl: ARDS is a clinical syndrome of inflammatory permeability oedema.

Reference: Faculty of Intensive Care Medicine; BTS oxygen guideline