MRCP Part 1 Question of the Day

Try today's Question of the Day and test your knowledge.

Questions include exam themes similar to the January 2015 MRCP Part 1 exam.

A 71-year-old man presents to the Emergency department with an influenza-like illness.

He says this has been accompanied by a dry cough and diarrhoea over the past few days, and his wife tells you that he is becoming increasingly drowsy and forgetful. They have returned from a hotel in Spain some two days earlier, where they were staying for the winter.

On examination he is pyrexial 38.2°C, pulse is 92 and BP is 100/60 mmHg. There is bilateral wheeze on auscultation of the chest.

Investigations show:

Haemoglobin 130 g/L (135-177)
White cell count 13.0 ×109/L (4-11)
Platelets 222 ×109/L (150-400)
Sodium 130 mmol/L (135-146)
Potassium 4.1 mmol/L (3.5-5)
Creatinine 129 µmol/L (79-118)
Alkaline phosphatase 30 U/L (39-117)
CXR Left sided pleural effusion and patchy consolidation

Which of the following is the most likely diagnosis?

(Please select 1 option)

Klebsiella pneumoniae
Legionella pneumophila
Mycoplasma pneumoniae
Staphylococcus aureus
Streptococcus pneumoniae

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