Paediatric emergencies: acute severe asthma add-on therapy: practice question

A Pediatrics 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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Pediatrics · Paediatric emergencies: acute severe asthma add-on therapy

Sample item

A 7-year-old with acute severe asthma has received three doses of nebulised salbutamol with ipratropium and oral prednisolone. He remains breathless with SpO2 91 percent and poor air entry. Which add-on is recommended?

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

The answer and the reasoning

B. Intravenous magnesium sulphate

In acute severe asthma that fails to respond to repeated bronchodilators and steroids, intravenous magnesium sulphate is the recommended next step. It relaxes bronchial smooth muscle, and the child needs monitoring for hypotension.

Option by option

  • A. Intravenous antibiotics

    Antibiotics are not indicated unless there is evidence of bacterial infection.

  • B. Intravenous magnesium sulphate (correct)

    Correct. Magnesium sulphate is the recommended add-on for severe asthma not responding to initial treatment.

  • C. Nebulised sodium cromoglycate

    Cromoglycate is a preventive agent and has no role in an acute attack.

  • D. Oral montelukast

    Montelukast has no established role in an acute severe attack.

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 Pediatrics question

What is the answer to this Pediatrics question?

The best answer is B, Intravenous magnesium sulphate. In acute severe asthma that fails to respond to repeated bronchodilators and steroids, intravenous magnesium sulphate is the recommended next step.

Why is "Intravenous antibiotics" not the answer?

Antibiotics are not indicated unless there is evidence of bacterial infection.

Why is "Nebulised sodium cromoglycate" not the answer?

Cromoglycate is a preventive agent and has no role in an acute attack.

Why is "Oral montelukast" not the answer?

Montelukast has no established role in an acute severe attack.

What concept does this question test?

It tests Paediatric emergencies: acute severe asthma add-on therapy in Pediatrics. It relaxes bronchial smooth muscle, and the child needs monitoring for hypotension.

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 Paediatric emergencies: acute severe asthma add-on therapy?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics 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.