Respiratory 8 Minutes Chloe Evans, 26 yo (Emergency Department)

Acute Exacerbation of Asthma / Dyspnoea

Candidate Instructions: Chloe Evans, 26, presents to Acute Admissions with acute breathlessness and wheezing after an upper respiratory infection. Take a focused history, assess asthma severity, and explain immediate steps.

Examiner Marking Checklist

Severity Assessment

✓ Assess speech: Complete sentences vs short phrases vs monosyllabic
✓ Inquire about peak expiratory flow (PEF) percentage baseline
✓ Past ITU admissions or intubations for asthma
✓ Current oral steroid use or frequent rescue inhaler usage

Trigger & Symptom History

✓ Preceding viral coryzal symptoms, fever, sore throat
✓ Allergen exposure (pets, pollen, dust, occupational)
✓ Nocturnal cough and diurnal peak flow variation
✓ Chest tightness and sputum colour

Critical Red Flags

⚠ Silent chest on auscultation (life-threatening asthma)
⚠ Cyanosis, exhaustion, altered mental status, or bradycardia
⚠ PEF < 33% of predicted or personal best

Post-Station Examiner Questions

Examiner: "What are the criteria for life-threatening asthma in an adult?"

Model Answer: Silent chest, cyanosis, poor respiratory effort, PEF < 33%, SpO2 < 92%, exhaustion, confusion, or normal/elevated PaCO2 on ABG.

Practise this patient scenario with real-time conversational voice simulation.

Practise This Case with Virtual Patient →