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NBME 23 Answers

nbme23/Block 2/Question#21

A 55-year-old man comes to the physician because of ...

FEV1/FVC: normal;
FVC: decreased;
Diffusing capacity of the lung for carbon monoxide: decreased


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the patient has asbestos which is restrictive (clue was pleural plaques) DLCO is decreased in intra-thoracic conditions (interstitial lung dz etc) and normal on extra-thoracic conditions (muscular issues)





Are all interstitial/restrictive lung diseases indicative of a LOW DLCO?

nlkrueger  only if it's an interstitial lung disease i believe. like polio can cause a "restrictive lung disease" but it's due to muscle effort and would expect to see a decrease in diffusing capacity (FA 2018 pg 657.2) +  
meningitis  Construction worker, Diffuse reticular opacities screamed restrictive and low DLCO for me. Anything that either adds fibrosis to alveoli, or thickens the diameter between alveoli and alveolar capillaries will cause low DLCO. +3