Respiratory: acute severe asthma: 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 · Respiratory: acute severe asthma

Sample item

A child with acute severe asthma has SpO2 of 90 percent, speaks in single words and has poor response to the first nebulisation. Which combination is appropriate?

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

The answer and the reasoning

D. Oxygen, repeated salbutamol with ipratropium, and systemic corticosteroids

Severe attacks are treated with oxygen to keep saturations above 94 percent, repeated short-acting beta-agonists with ipratropium bromide in the first hour and early systemic steroids. Magnesium sulphate IV is used for refractory cases. Sedatives are dangerous.

Option by option

  • A. Sedation and nebulised saline

    Sedation may precipitate respiratory failure.

  • B. Oxygen and antibiotics

    Antibiotics are not indicated unless infection is proven.

  • C. Oral montelukast only

    Montelukast does not act quickly enough.

  • D. Oxygen, repeated salbutamol with ipratropium, and systemic corticosteroids (correct)

    Correct. Oxygen, bronchodilators and steroids.

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 D, Oxygen, repeated salbutamol with ipratropium, and systemic corticosteroids. Severe attacks are treated with oxygen to keep saturations above 94 percent, repeated short-acting beta-agonists with ipratropium bromide in the first hour and early systemic steroids.

Why is "Sedation and nebulised saline" not the answer?

Sedation may precipitate respiratory failure.

Why is "Oxygen and antibiotics" not the answer?

Antibiotics are not indicated unless infection is proven.

Why is "Oral montelukast only" not the answer?

Montelukast does not act quickly enough.

What concept does this question test?

It tests Respiratory: acute severe asthma in Pediatrics. Magnesium sulphate IV is used for refractory cases. Sedatives are dangerous.

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: acute severe asthma?

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.