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Pulmonary vasculitis with alveolar haemorrhage — SCE Acute Medicine MCQ

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HardAcute Respiratory PresentationsPulmonary vasculitis with alveolar haemorrhageSCE Acute Medicine

A 52-year-old woman is assessed on the acute medical unit. She has haemoptysis, falling haemoglobin and new renal impairment. Urinalysis shows blood and protein, and chest CT shows diffuse alveolar infiltrates. Initial assessment includes relevant observations, bedside tests and urgent blood results. What is the most likely diagnosis?

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Correct answer: C — Pulmonary renal vasculitis

Pulmonary renal vasculitis is the best answer because the combination of pulmonary haemorrhage and active urinary sediment suggests pulmonary renal vasculitis. Status epilepticus 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: This presentation requires urgent renal, respiratory and immunology input.

Reference: BSR vasculitis guideline