Restrictive Lung Disease USMLE Step 1 Practice Question
A 52-year-old woman presents to clinic with a 6-month history of progressive dyspnea on exertion and dry cough. She denies occupational exposures, smoking history, and recent infections. Vital signs include BP 128/82 mmHg, HR 98 bpm, RR 22/min, and SpO2 92% on room air. Physical examination reveals bilateral hilar lymphadenopathy and mild ankle edema. Chest X-ray shows bilateral upper lobe predominant reticulonodular opacities with hilar and mediastinal lymphadenopathy. High-resolution CT confirms upper lobe-predominant fibrosis with preserved lung bases. Pulmonary function tests demonstrate FVC 65% predicted with normal DLCO-to-alveolar volume ratio. Laboratory studies show elevated serum angiotensin-converting enzyme (ACE) level and hypercalcemia. Which of the following is the most likely diagnosis?
Answer choices
- AIdiopathic pulmonary fibrosis
- BSarcoidosisCorrect answer
- CSilicosis
- DHypersensitivity pneumonitis
- EAsbestos-related lung disease
- FTalcosis
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