American Board of Internal Medicine (ABIM) Certification Practice Exam

What is a common treatment for severe persistent asthma?

1. Use of short-acting bronchial dilators

2. Daily inhaled glucocorticoids

3. Severe exercise avoidance

4. Intermittent use of leukotriene receptor antagonists

The correct answer is: Daily inhaled glucocorticoids

Daily inhaled glucocorticoids are a fundamental treatment for severe persistent asthma because they help control inflammation in the airways and reduce the frequency of exacerbations. In severe persistent asthma, the inflammation is often more intense, and therefore, a consistent, daily anti-inflammatory treatment is necessary to maintain long-term control of symptoms. Inhaled glucocorticoids help reduce airway hyperresponsiveness and improve lung function, which is crucial for patients experiencing significant and persistent asthma symptoms. These medications are typically considered the first-line therapy for long-term control and are effective in managing the underlying inflammatory process associated with asthma. Other treatments such as short-acting bronchial dilators serve as quick relief for acute symptoms but do not provide the ongoing control needed for severe persistent cases. Severe exercise avoidance is generally not a recommended strategy since physical activity can be beneficial for overall health, and with proper management, most patients can safely engage in exercise. Intermittent use of leukotriene receptor antagonists can help in certain cases, but they are typically not sufficient as a standalone treatment for severe persistent asthma without the use of inhaled glucocorticoids.