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Near-fatal asthma — MCCQE Part 1 MCQ

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HardDyspneaNear-fatal asthmaMCCQE Part 1

A 28-year-old asthmatic in severe distress. PEFR 25% predicted. No improvement after three rounds of salbutamol + ipratropium. Most appropriate next step?

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Correct answer: D — IV magnesium sulphate and prepare for possible intubation

Near-fatal asthma (PEFR <25%, refractory): IV MgSO4 2g over 20 min. Alert ICU. Systemic corticosteroids should already be given. Intubation is high-risk in status asthmaticus.

Reference: CTS Asthma Exacerbation