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NBME 22 Answers

nbme22/Block 1/Question#36

A 67-year-old woman comes to the physician because ...

Idiopathic pulmonary fibrosis

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1st clue is that its a restrictive lung disease via the FEV1/FVC ratio being increased.

Next, the DLCO is decreased (normal is 80 to 120%), meaning an issue with the alveolar-pulmonary capillary barrier (a diffuse lung process).

The CT has classic findings for idiopathic pulmonary fibrosis.

The clinical picture (non-productive cough, SOB with exertion, afebrile) are consistent with idiopathic pulmonary fibrosis.

Overall a very non ambiguous question.