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Acute chest syndrome in sickle cell disease — SCE Acute Medicine MCQ

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EasyAcute Respiratory PresentationsAcute chest syndrome in sickle cell diseaseSCE Acute Medicine

A 24-year-old man is assessed on the acute medical unit. He has sickle cell disease, fever, chest pain and new hypoxia during an acute painful crisis. Chest radiograph shows a new lower-zone infiltrate. Initial assessment includes relevant observations, bedside tests and urgent blood results. What is the most likely diagnosis?

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

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Correct answer: D — Acute chest syndrome

Acute chest syndrome is the best answer because new pulmonary infiltrate with fever or respiratory symptoms in sickle cell disease defines acute chest syndrome. Massive haemoptysis 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 transfusion discussion is important when hypoxia progresses.

Reference: NICE sickle cell acute painful episode guidance