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Lymphangioleiomyomatosis — RACP Adult Medicine MCQ

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HardRespiratoryLymphangioleiomyomatosisRACP Adult Medicine

A 43-year-old with acute severe asthma initially had marked tachypnoea and wheeze. After repeated bronchodilators she becomes drowsy, respiratory rate falls to 10/min and air entry is barely audible; oxygen saturation is 96% on high-flow oxygen. What is the priority?

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Reveal the answer and explanation

Correct answer: C — Escalate immediately for intensive-care airway and ventilatory support

Explanation lettering: D = shown as A · A = shown as B · B = shown as C · C = shown as D

B is correct. Drowsiness, bradypnoea and a silent chest indicate exhaustion and impending ventilatory arrest despite preserved oxygenation. C delays support. D confuses oxygenation with ventilation. E is unsafe and unnecessary in life-threatening asthma. A mistakes fatigue for recovery.

Reference: Australian Asthma Handbook, Managing acute asthma in adults in the emergency department: https://www.asthmahandbook.org.au/acute-asthma/adults-and-adolescents/managing-acute-asthma-in-adults-and-adolescents-in-the-ed