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Aspiration pneumonitis — SCE Acute Medicine MCQ

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EasyAcute Respiratory PresentationsAspiration pneumonitisSCE Acute Medicine

A 82-year-old woman is assessed on the acute medical unit. She vomits during a seizure and develops sudden hypoxia within one hour. Temperature is normal, CRP is unchanged and chest radiograph shows dependent right lower-zone shadowing. Initial assessment includes relevant observations, bedside tests and urgent blood results. What is the most likely diagnosis?

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Correct answer: C — Aspiration pneumonitis

Aspiration pneumonitis is the best answer because the abrupt respiratory deterioration immediately after witnessed aspiration favours chemical pneumonitis rather than established bacterial pneumonia. Acute severe asthma 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: Early aspiration pneumonitis can improve with supportive care; antibiotics are not automatic.

Reference: BTS Clinical Statement on Aspiration Pneumonia