🏥 USMLE Exam Prep

A 7-year-old child presents with a 2-day history of wheezing, cough, and shortness of breath. His parents report he has used his albuterol inhaler every 3 hours with only temporary relief. On examination, he is tachypneic, has mild retractions, and expiratory wheezing throughout lung fields. His oxygen saturation is 92% on room air. What is the most appropriate initial management in the emergency department?

A Oral prednisone and discharge home
B Inhaled albuterol and ipratropium via nebulizer, systemic corticosteroids
C Intravenous magnesium sulfate
D Intubation and mechanical ventilation

✓ Correct Answer: Option B

This child is experiencing a moderate asthma exacerbation. Initial management includes repetitive or continuous inhaled short-acting beta-agonists (albuterol) and anticholinergics (ipratropium), along with systemic corticosteroids to reduce inflammation. Oxygen therapy is also indicated for hypoxemia.

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