American Board of Internal Medicine (ABIM) Certification Practice Exam

Which of the following symptoms indicates moderate persistent asthma?

1. Symptoms not occurring daily

2. FEV1 ≥ 80% of predicted

3. Interference with normal activities

4. Nighttime awakenings fewer than once per week

The correct answer is: Interference with normal activities

The categorization of asthma symptoms helps guide treatment strategies and management plans. In moderate persistent asthma, patients typically experience symptoms on a daily basis and may have limited responsiveness to standard medications. Interference with normal activities is a key indicator of moderate persistent asthma. Patients experiencing this level of asthma are likely to face restrictions in their daily life due to respiratory symptoms, indicating that their condition is not adequately controlled. This interference suggests that their asthma is more than mild in severity and is affecting their quality of life significantly. In contrast, daily symptoms might be expected in this context, but the other options reflect criteria that are characteristic of milder forms of asthma or better-controlled asthma. For instance, symptoms not occurring daily or nighttime awakenings fewer than once per week suggest better control and are not indicative of moderate persistent asthma. Furthermore, maintaining an FEV1 of ≥ 80% of predicted also points towards better asthma control, which again is not aligned with moderate persistent asthma, where lung function may be compromised more significantly. Thus, the presence of symptoms that interfere with normal activities is what accurately characterizes moderate persistent asthma within the options provided.