skip to main content

Empyema complicating pneumonia — SCE Acute Medicine MCQ

Instant feedback + full explanation. One question, done properly.

EasyAcute Respiratory PresentationsEmpyema complicating pneumoniaSCE Acute Medicine

A 69-year-old man is assessed on the acute medical unit. He has persistent fever after 72 hours of pneumonia treatment. Chest radiograph shows a moderate unilateral effusion and inflammatory markers remain high. Initial assessment includes relevant observations, bedside tests and urgent blood results. What is the most appropriate investigation?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Bedside ultrasound for pleural fluid

Bedside ultrasound for pleural fluid is the best answer because ultrasound confirms pleural fluid, guides safe sampling and helps identify septations suggesting pleural infection. Urgent transthoracic echocardiography 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: Pleural fluid pH is a key discriminator for drainage in parapneumonic effusion.

Reference: BTS Pleural Disease Guideline