<prompt> A 4 year child with bronchial asthma presents history of with and 3 and more episodes during daytime in a week and 2 wheezing episodes during night in a month. How will you grade this asthma?Mild PersistentModerate PersistentSevere PersistentMild intermittent  <response>: Ref: Nelsons Textbook of Pediatrics. 19th Edition, Page: 790.Explanation:This is a straightforward question to assess whether you know the recent NAEPP classification of chronic asthma 2007.Be aware that there are some changes to the previous classification 2002. Latest edition of Nelson gives the most recent classification 2007 and the same is given below. See table on below National Asthma Education and Prevention Program NAEPP Classification of asthmaCOMPONENTS OFCLASSIFICATION OF ASTHMA SEVERITYSEVERITYMild IntermittentMild PersistentModerate PersistentSeverePersistentImpairment Daytime symptoms 2 dayswk2 dayswk but not dailyDailyThroughout the dayNighttime awakenings Age 0-4 yr Age 5 yr 02 xmonth1-2xmo3-4xmo3-4xmo1xwk but not nightly1xwkOften 7xwkShort-acting b2-agonist use forsymptoms2 dayswk2 dayswk but not daily, and not more than 1 x on any dayDailySeveral times per dayInterference with normal activityNoneMinor limitationSome limitationExtremelimitationLung function: FEV1 predictedage 5 yrNormal FEV1betweenexacerbations 80predicted 60- 80 predicted 60predicted 80predictedFEV1FVC ratio Age 5- 11 yr Age 2 yrRisk 85Normal80Normal75-80 Reduced 575Reduced 5Exacerbations requiring systemic corticosteroids: Age 0-4 yr0-1yr 2 exacerbations in 6 mo requiring systemic corticosteroids or 4 wheezing episodesyr lasting 1 day and risk factors for persistent asthma Age 5 yr0-1yr 2;yr 