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Asthma exacerbation — MCCQE Part 1 MCQ

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ModerateDyspneaAsthma exacerbationMCCQE Part 1

A 19-year-old woman with asthma has wheeze, cannot complete sentences, oxygen saturation 90% and peak flow 38% predicted after salbutamol at home. Which of the following is the most appropriate next step?

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Correct answer: CGive oxygen, repeated inhaled salbutamol and ipratropium, and systemic corticosteroids

Give oxygen, repeated inhaled salbutamol and ipratropium, and systemic corticosteroids is the single best answer because the age, timing, examination findings and investigations in the vignette fit Asthma exacerbation better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to CTS asthma guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: CTS asthma guidance