Restrictive Lung Disease USMLE Step 1 Practice Question
A 68-year-old man with a 40 pack-year smoking history and 30 years of occupational exposure to asbestos presents to clinic with progressive dyspnea on exertion and pleuritic chest pain over 6 months. He denies hemoptysis, fever, or weight loss. Vital signs: BP 138/82 mmHg, HR 92/min, RR 22/min, SpO2 88% on room air. Physical examination reveals decreased breath sounds bilaterally at the lung bases. Chest CT shows bilateral lower lobe pleural thickening with calcified pleural plaques and mild basilar fibrosis. Pulmonary function tests reveal: FVC 65% predicted, FEV1 68% predicted, FEV1/FVC ratio 0.82, DLCO 58% predicted. Which of the following is the most likely diagnosis?
Answer choices
- AIdiopathic pulmonary fibrosis
- BSarcoidosis with pulmonary involvement
- CAsbestos-related pleural disease with asbestosisCorrect answer
- DSilicosis
- EHypersensitivity pneumonitis
- FDesquamative interstitial pneumonia
See the full explanation
Get the correct-answer rationale, why each distractor is wrong, the underlying mechanism, and high-yield associations — plus adaptive practice that targets your weak areas — with a free MedBoardPRO account.