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Severe community-acquired pneumonia — SCE Acute Medicine MCQ

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EasyAcute Respiratory PresentationsSevere community-acquired pneumoniaSCE Acute Medicine

A 67-year-old man is assessed on the acute medical unit. He has fever, pleuritic chest pain and confusion. Respiratory rate is 32/min, blood pressure is 88/54 mmHg, urea is 11 mmol/L and chest radiograph shows right lower-zone consolidation. Initial assessment includes relevant observations, bedside tests and urgent blood results. What is the most appropriate next step in management?

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

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Correct answer: A — Give broad-spectrum intravenous antibiotics within one hour

Give broad-spectrum intravenous antibiotics within one hour is the best answer because the CURB-65 features and hypotension indicate severe pneumonia with sepsis physiology requiring prompt intravenous antimicrobials and resuscitation. Give intramuscular adrenaline 500 micrograms 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: CURB-65 guides severity, but treatment should not be delayed when shock physiology is present.

Reference: NICE NG138; BTS CAP guideline