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Acute Asthma — MRCGP AKT MCQ

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HardRespiratory MedicineAcute AsthmaMRCGP AKTMRCEM SBAUKMLAPARA

A 46-year-old has fever, neck stiffness, photophobia, confusion and a non-blanching rash. Bacterial meningitis is strongly suspected; there is no contraindication to ceftriaxone. Which dexamethasone plan is correct?

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Correct answer: C — Give IV dexamethasone with the first antibiotic; do not delay antibiotics

C is correct. NICE recommends IV dexamethasone for people over 3 months with strongly suspected bacterial meningitis, ideally with or before the first antibiotic, but antibiotics must not be delayed. A permits a dangerous delay. B waits for organism confirmation. D misses the evidence-based timing. E contradicts NICE. Subsequent continuation depends on the organism or infection-specialist advice.

Reference: NICE NG240: bacterial meningitis and meningococcal disease: https://www.nice.org.uk/guidance/ng240/chapter/recommendations GMC: PA registration assessment content map: https://www.gmc-uk.org/education/standards-guidance-and-curricula/standards-and-outcomes/pa-and-aa-prequalification-education-framework/pa-registration-assessment-content-map