Respiratory medicine: acute severe asthma: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Respiratory medicine: acute severe asthma

Sample item

A young woman with acute severe asthma has a peak flow of 40 percent predicted and cannot complete sentences. Which combination is the appropriate initial treatment?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Oxygen, nebulised salbutamol with ipratropium and systemic corticosteroid

Acute severe asthma requires oxygen to keep saturation 93-95 percent, repeated nebulised beta-2 agonists with ipratropium, and early systemic corticosteroid. Intravenous magnesium is added if there is poor response. Sedatives are avoided.

Option by option

  • A. Intravenous antibiotics and codeine

    Antibiotics are not routinely required and codeine can depress respiration.

  • B. Oxygen, nebulised salbutamol with ipratropium and systemic corticosteroid (correct)

    Correct. This is the standard first-hour package.

  • C. Inhaled corticosteroid alone

    Inhaled steroid alone is inadequate in an acute attack.

  • D. Oral theophylline and bed rest

    Theophylline is second line and not an initial measure.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is B, Oxygen, nebulised salbutamol with ipratropium and systemic corticosteroid. Acute severe asthma requires oxygen to keep saturation 93-95 percent, repeated nebulised beta-2 agonists with ipratropium, and early systemic corticosteroid.

Why is "Intravenous antibiotics and codeine" not the answer?

Antibiotics are not routinely required and codeine can depress respiration.

Why is "Inhaled corticosteroid alone" not the answer?

Inhaled steroid alone is inadequate in an acute attack.

Why is "Oral theophylline and bed rest" not the answer?

Theophylline is second line and not an initial measure.

What concept does this question test?

It tests Respiratory medicine: acute severe asthma in General Medicine. Intravenous magnesium is added if there is poor response. Sedatives are avoided.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Respiratory medicine: acute severe asthma?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.