A 24-year-old asthmatic arrives in the emergency department during an acute attack. Which single finding places her in the life-threatening category rather than acute severe asthma?

• A Inability to complete sentences in one breath
• B Use of accessory muscles of respiration
• C Peak expiratory flow 55% of predicted
• D Silent chest on auscultation ✓

Explanation

Silent chest indicates such severe airflow limitation that gas movement is insufficient to produce wheeze, and it defines a life-threatening attack. Sentence-breaking speech, accessory muscle use, and a PEF of 50 to 75% predicted are features of acute severe asthma, one tier below. Pulsus paradoxus likewise belongs to the severe, not life-threatening, category.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.