ADC Practice Question — Spreading infections without severe features

What is the most likely diagnosis given the clinical presentation?

Pharmacology questions in the ADC written exam test applied prescribing decisions, not rote recall of drug names. This exam-level vignette tests your ability to work through clinical details and arrive at the correct management.

Priya Sharma, a 24-year-old pregnant woman at 28 weeks gestation, presents to the emergency department with severe facial swelling and difficulty swallowing that started 2 days ago following dental pain from a lower left molar. She appears anxious and is sitting upright, leaning forward. On examination, there is bilateral swelling of the floor of mouth extending to the neck, trismus limiting mouth opening to 15mm, and muffled speech. Her temperature is 38.2°C, pulse 110 bpm, BP 125/85 mmHg, oxygen saturation 94% on room air. She reports increasing difficulty swallowing saliva. What is the most likely diagnosis given the clinical presentation?

A. Ludwig angina
B. Postoperative infection
C. Localised dental abscess
D. Salivary gland infection
E. Alveolar osteitis

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Sources cited

Therapeutic Guidelines v4 Odell's 3rd & 4th Ed IADT 2020 Code of Conduct CMS (Evans) Infection Control + more

Show the answer and cited explanation

Correct answer: A

According to TG, Ludwig angina is defined as a severe spreading infection involving the bilateral submandibular, sublingual and submental spaces, with cellulitis and risk of airway compromise, which matches this presentation.

Source: Ch 13: Spectrum of acute odontogenic infections

Remy's study tip — For pharmacology vignettes, read the patient’s medical history and allergies BEFORE looking at the drug options.

Exam preparation FAQ

How are Spreading infections without severe features questions structured in the ADC written exam?

ADC Spreading infections without severe features questions present as clinical vignettes requiring management decisions. The correct answer is always traceable to a guideline source.

Should I memorise guidelines word-for-word for Spreading infections without severe features?

Focus on decision points — when the guideline says X vs Y. The exam tests application, not recitation.

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