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Retired NBME 22 Answers

nbme22/Block 1/Question#36 (reveal difficulty score)
A 67-year-old woman comes to the physician ...
Idiopathic pulmonary fibrosis ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—ergogenic22(401)
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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.

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timewizard  Thank you for the explanation, but no need for the "non ambiguous" part. I'm denser than a neutron star and struggled mightily with this question. +3



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