UKMLA PLAB AMC USMLE Prometric MCQ

Question Number 0970

Question:
An 11 year old boy known asthmatic is brought to the Casualty Department in a confused state. On examination he appears distressed and unwilling to lie down. Ausculatation of his chest does not reveal any wheezing. It is noted that he has marked sternal retraction and is inable to speak in more than monosyllables. There is a lowering in the systemic systolic blood pressure by 25mmHg during inspiration. Appropriate management should include

a) refer to an ENT specialist
b) emergency treatment and immediate transfer to intensive care unit
c) iv theophylline
d) Nebulised ipratropium bromide
e) Single dose 1 ml 0.5% salbutamol