American Board of Internal Medicine (ABIM) Certification Practice Exam

What mMRC score indicates a mild level of dyspnea in COPD patients?

1. 0-1

2. 2-3

3. 4-5

4. 6-7

The correct answer is: 0-1

The modified Medical Research Council (mMRC) dyspnea scale is a tool used to assess the degree of breathlessness in patients, particularly those with chronic obstructive pulmonary disease (COPD). A score of 0 indicates that the individual experiences breathlessness only with strenuous exercise, while a score of 1 reflects breathlessness when hurrying or walking up a slight hill. These scores (0-1) represent a mild level of dyspnea, as they suggest that the patient experiences relatively low or infrequent breathlessness and maintains a level of functional independence. In contrast, higher scores indicate more significant limitations and greater symptoms. For instance, a score of 2 suggests the individual walks slower than others due to breathlessness or has to stop for breath when walking at their own pace, which represents a more notable level of dyspnea. Scores of 3 and above further reflect increased severity, as they indicate breathlessness with daily activities and even at rest. The higher the score, the more severe the perception of breathlessness, pointing towards a poorer prognosis and greater impairment in daily functioning in COPD patients. Understanding these scores helps healthcare providers gauge the impact of dyspnea on patients' quality of life and informs treatment decisions and management strategies