Restrictive Lung Disease USMLE Step 1 Practice Question
A 55-year-old man presents with a 3-month history of progressive dyspnea on exertion. He reports no fever, weight loss, or sick contacts. Past medical history is significant for primary biliary cirrhosis diagnosed 5 years ago. Vital signs include BP 132/78 mmHg, HR 92 bpm, RR 22/min, and SpO2 88% on room air. High-resolution CT chest shows basilar and biapical interstitial opacities with hilar lymphadenopathy. Pulmonary function testing demonstrates FVC 62% predicted, FEV1 68% predicted, with FEV1/FVC ratio of 78%. Transbronchial biopsy reveals non-caseating granulomas. Laboratory studies show normal ACE level and normal serum calcium. Which of the following is the most likely diagnosis?
Answer choices
- APulmonary sarcoidosisCorrect answer
- BChronic hypersensitivity pneumonitis
- CHepatopulmonary syndrome
- DAsbestos-induced pulmonary fibrosis
- EIdiopathic pulmonary arterial hypertension
- FTalcosis from intravenous drug use
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