Restrictive Lung Disease USMLE Step 1 Practice Question
A 67-year-old man with prior mediastinal radiation for lymphoma 15 years ago presents with progressive dyspnea. Vital signs: BP 142/88, HR 98, RR 22, SpO2 88% on room air. Chest X-ray shows bilateral lower lobe fibrosis with mediastinal fibrosis. PFTs reveal reduced TLC and FVC with normal FEV1/FVC ratio. He denies orthopnea. Which pathologic process best explains his restrictive lung disease?
Answer choices
- ACardiogenic pulmonary edema from radiation-induced heart disease
- BInfectious pneumonia from chemotherapy-induced immunosuppression
- CRecurrent lymphoma with leukostasis
- DRadiation-induced alveolitis with progressive pulmonary fibrosisCorrect answer
- EBronchiolitis obliterans from graft-versus-host disease
- FAsbestos-related pleural thickening with lung fibrosis from occupational exposure
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