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Acute pleuritic chest pain from pneumonia — SCE Acute Medicine MCQ

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EasyAcute Respiratory PresentationsAcute pleuritic chest pain from pneumoniaSCE Acute Medicine

A 45-year-old man is assessed on the acute medical unit. He has fever, cough productive of rusty sputum and pleuritic pain. Respiratory rate is 26/min and chest radiograph shows lobar consolidation. Initial assessment includes relevant observations, bedside tests and urgent blood results. What is the most likely diagnosis?

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Correct answer: B — Community-acquired pneumonia

Community-acquired pneumonia is the best answer because fever, productive cough, focal chest signs and lobar consolidation are most consistent with community-acquired pneumonia. Septic shock 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: Pleuritic pain does not equal PE when infection features are dominant.

Reference: BTS CAP guideline; NICE NG138