Hospital-acquired pneumonia — SCE Respiratory MCQ

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HardRespiratory InfectionsHospital-acquired pneumoniaSCE Respiratory

A 76-year-old inpatient develops fever, purulent sputum and new oxygen requirement 7 days after hip surgery. Chest radiograph shows new left lower-zone consolidation. MRSA screen is negative and local resistance rates are low. What is the most likely diagnosis?

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Correct answer: D — Hospital-acquired pneumonia

The best answer is “Hospital-acquired pneumonia”. The clinical pattern, physiology and imaging described are most consistent with Hospital-acquired pneumonia. The competing diagnoses may share individual findings, but do not account for the complete combination in the stem. The remaining choices—“Community-acquired pneumonia, after safety review”, “Aspiration pneumonitis in the absence of infection”, “Pulmonary oedema, with clinical reassessment”, “Idiopathic pulmonary fibrosis”—are credible in related respiratory presentations, but each addresses a different diagnostic, staging or management decision and does not fit the decisive findings and pathway position in this stem.

Reference: British Thoracic Society guideline for home oxygen: https://thorax.bmj.com/content/70/Suppl_1/i1