Question

Consider the following statements. The features of severe asthma include:

1. Central cyanosis.
2. Disturbance of consciousness.
3. Pulsus paradoxus.
4. Heart rate less than 60 per minute.

Which of these statements are correct?

• A. 2, 3 and 4
• B. 1, 3 and 4
• C. 1, 2 and 3
• D. 1, 2 and 4

Hint:

Severe asthma causes tachycardia and hypoxia signs, not a slow heart rate.

Answer 1

The Correct Option is C

Step 1: Recall the markers of a severe or life-threatening asthma attack.
A severe asthma attack is marked by hypoxia and exhaustion of the respiratory muscles. Central cyanosis (statement 1) shows up when oxygen saturation has fallen enough to affect the tongue and lips, so it is a true marker of a severe attack.

Step 2: Look at disturbance of consciousness.
As hypoxia and rising carbon dioxide worsen, the brain is starved of oxygen and the patient becomes drowsy or confused. Disturbance of consciousness (statement 2) is one of the most worrying signs, and it is true.

Step 3: Look at pulsus paradoxus.
In a severe attack, big swings in intrathoracic pressure during laboured breathing exaggerate the normal fall in blood pressure on inspiration. Pulsus paradoxus (statement 3) is a recognised sign of severe airway obstruction, so it is true.

Step 4: Look at the heart rate claim.
Severe asthma drives tachycardia, not bradycardia, because of hypoxia, anxiety, and use of beta-agonist inhalers. A heart rate under 60 per minute (statement 4) is not a routine feature of severe asthma. A falling heart rate in this setting is instead a pre-terminal sign of exhaustion and impending arrest, so statement 4 is false.

Step 5: Combine the correct statements.
Statements 1, 2, and 3 are true, while statement 4 is false.

Step 6: Final answer.
\[ \boxed{1,\ 2\ \text{and}\ 3} \]