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Life-threatening asthma — RCPSC EM MCQ

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HardRespiratory emergenciesLife-threatening asthmaRCPSC EM

A 19-year-old woman with asthma is CTAS 1 with silent chest, exhaustion, and oxygen saturation 88% despite continuous salbutamol. ABG shows pH 7.21, PaCO2 56 mmHg, and lactate 5.0 mmol/L. She has already received steroids and magnesium. What is the most likely diagnosis?

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Correct answer: E — Life-threatening asthma with impending respiratory failure

Silent chest, exhaustion, hypoxaemia, acidosis, and rising carbon dioxide in asthma indicate impending respiratory failure.

Reference: Canadian Thoracic Society asthma guidance; ACLS airway principles