7 board-style questions on interstitial lung disease in the PulseMD family medicine question bank, written against current guidelines with the reference cited on each question. Two free samples below; the full set with answers, explanations, and spaced review is free to start.
A 56-year-old woman with a 20-year history of rheumatoid arthritis on methotrexate presents with 6 months of progressive dyspnea on exertion and a dry, nonproductive cough. Physical examination reveals bilateral fine inspiratory crackles at the lung bases and digital clubbing. Chest CT shows bilateral peripheral reticular opacities with honeycombing and traction bronchiectasis predominantly in the lower lobes. Pulmonary function tests show FVC 62% predicted, FEV1 70% predicted, FEV1/FVC ratio 0.82, and DLCO 48% predicted. What is the most likely diagnosis?
A 65-year-old man with idiopathic pulmonary fibrosis (IPF) confirmed by UIP pattern on high-resolution CT and multidisciplinary discussion presents with progressive dyspnea. His FVC is 72% predicted. He has no contraindications to antifibrotic therapy. Which medication has been shown to slow the decline of lung function in IPF?
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