🏥 USMLE Exam Prep

A 35-year-old female presents to the emergency department with severe dyspnea, wheezing, and accessory muscle use. She has a history of asthma and uses an albuterol inhaler. Her oxygen saturation is 88% on room air. Her peak expiratory flow (PEF) is 30% of her personal best. What is the most appropriate initial management step?

A Administer intravenous magnesium sulfate.
B Initiate continuous nebulized albuterol and ipratropium, systemic corticosteroids, and oxygen.
C Prepare for emergent intubation.
D Administer subcutaneous epinephrine.

✓ Correct Answer: Option B

Initial management of severe asthma exacerbation includes supplemental oxygen, frequent or continuous inhaled short-acting beta-agonists (albuterol) and anticholinergics (ipratropium), and systemic corticosteroids. These interventions rapidly target bronchoconstriction and inflammation.

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