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Acute asthma — MRCPCH FOP MCQ

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HardRespiratoryAcute asthmaMRCPCH FOP

An 8-year-old girl with asthma has severe wheeze after a viral illness. Her oxygen saturation is 91% in air, respiratory rate 38/min, pulse 145/min and peak flow is 42% predicted after two salbutamol puffs at home. What is the most likely cause?

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Correct answer: C — Acute airway inflammation with bronchoconstriction triggered by infection

The low peak flow, hypoxia, tachypnoea and wheeze in a child with asthma indicate acute airway inflammation and bronchoconstriction, commonly triggered by viral infection. Croup causes stridor and barking cough rather than reduced peak flow from lower-airway obstruction. Heart failure may cause respiratory distress but would not typically produce this reversible wheezy pattern. The pearl is that objective peak flow helps grade severity in children old enough to perform it.

Reference: BTS/NICE/SIGN Asthma guideline 2024; BNFc