American Board of Internal Medicine (ABIM) Certification Practice Exam

Which condition characterizes severe persistent asthma?

1. Lung function with FEV1 ≥ 80% of predicted

2. Symptoms throughout the day

3. Minor limitations in activities

4. FEV1/FVC normal

The correct answer is: Symptoms throughout the day

Severe persistent asthma is characterized by frequent and ongoing symptoms, which is why the presence of symptoms throughout the day is a defining feature. This level of asthma severity significantly impacts the patient's daily life, necessitating daily medication and often leading to nighttime awakenings. In patients with severe persistent asthma, symptoms are not just limited to physical activity; they can occur at rest and may severely limit normal daily functions. Affected individuals often experience exacerbations that can be triggered by various factors, requiring frequent use of rescue inhalers. The other conditions mentioned do not align with the definition of severe persistent asthma. For instance, lung function levels like FEV1 ≥ 80% of predicted indicate a less severe form of asthma. Minor limitations in activities and a normal FEV1/FVC ratio suggest well-controlled or mild intermittent symptoms rather than the persistent and significant impact seen in severe cases. Therefore, the consistent presence of symptoms throughout the day provides a clear indication of severe persistent asthma.