ADC Practice Question — Surgical management principles

What is the most serious potential complication that…

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 serious potential complication that requires immediate attention?

A. Sepsis
B. Osteomyelitis
C. Airway obstruction
D. Medication allergy
E. Fetal compromise

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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: C

According to TG, severe local features indicate risk of airway compromise, and Ludwig angina specifically involves cellulitis with risk of airway compromise, making this the most immediate life-threatening concern.

Source: Ch 13: Severe local features and Ludwig angina

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 Surgical management principles questions structured in the ADC written exam?

ADC Surgical management principles 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 Surgical management principles?

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

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