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Turner – oestrogen — RACP Paediatrics MCQ

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HardEndocrineTurner – oestrogenRACP Paediatrics

A 12-year-old with acute asthma initially had marked recession and tachypnoea. Despite repeated bronchodilator treatment he is now drowsy, has minimal air entry, respiratory rate 10/min and a normal oxygen saturation on supplemental oxygen. What is the priority?

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Reveal the answer and explanation

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

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

C is correct. Drowsiness, bradypnoea and poor air entry after initial distress signify exhaustion and life-threatening ventilatory failure; supplemental oxygen can preserve saturation while carbon dioxide rises. A delays airway support. B mistakes oxygenation for ventilation. D spirometry is unsafe and unhelpful in impending failure. E reduced effort here reflects fatigue rather than recovery.

Reference: RCH Melbourne, Assessment of severity of respiratory conditions: https://www.rch.org.au/clinicalguide/guideline_index/Assessment_of_severity_of_respiratory_conditions/