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Acute paediatric asthma exacerbation — MCCQE Part 1 MCQ

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ModerateWheezingAcute paediatric asthma exacerbationMCCQE Part 1

A 10-year-old boy with asthma presents with cough and wheeze after a viral illness. He speaks in phrases, oxygen saturation is 91%, respiratory rate is 34/min, and peak flow is 45% predicted. What is the most appropriate next step in management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Give inhaled salbutamol, ipratropium, systemic corticosteroids and controlled oxygen

Moderate to severe asthma exacerbation requires rapid bronchodilation with salbutamol, ipratropium for severe features, systemic corticosteroids and oxygen. Spirometry should not delay acute treatment. LABA monotherapy is unsafe and not acute rescue therapy.

Reference: CPS acute asthma exacerbation guidance