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Community-acquired pneumonia — MCCQE Part 1 MCQ

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ModerateCoughCommunity-acquired pneumoniaMCCQE Part 1

A 72-year-old woman with chronic kidney disease presents with fever, productive cough and pleuritic discomfort. Temperature is 38.7°C, respiratory rate 24/min, oxygen saturation 93%, and chest x-ray shows a right lower-lobe infiltrate. She is mildly confused and lives alone. What is the most appropriate next step in management?

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Correct answer: D — Admit to hospital and start empiric antibiotics for community-acquired pneumonia

Age, confusion, tachypnoea and radiographic consolidation indicate community-acquired pneumonia requiring admission and empiric antibiotics. Waiting for repeat imaging before treatment risks deterioration. Oseltamivir may be added if influenza is suspected, but it is not adequate treatment for bacterial pneumonia.

Reference: Association of Medical Microbiology and Infectious Disease Canada CAP guidance; MCC Objectives—Cough