Rosh Internal Medicine Boost Practice Exam

What symptom is most characteristic of a patient experiencing a severe asthma exacerbation?

1. Persistent fever

2. Wheezing

3. Chest tightness

4. Productive cough

The correct answer is: Wheezing

Wheezing is the most characteristic symptom of a patient experiencing a severe asthma exacerbation. It occurs due to the narrowing of the airways as a result of bronchospasm, inflammation, and increased mucus production, which are hallmark features of asthma. Wheezing is typically described as a high-pitched whistling sound that occurs during expiration and can also be present during inspiration in severe cases. While chest tightness is also a common symptom in asthma, and productive cough can occur, wheezing is directly associated with the acute airflow limitation that defines an exacerbation. Persistent fever is generally not associated with asthma and would suggest a different underlying condition, possibly an infection or another respiratory issue. Thus, in the context of severe asthma exacerbations, wheezing stands out as a defining symptom that indicates respiratory distress.