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Interstitial lung disease — MCCQE Part 1 MCQ

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EasyDyspneaInterstitial lung diseaseMCCQE Part 1

A 62-year-old man has progressive exertional dyspnoea, dry cough, bibasal fine crackles, exertional desaturation and reticular changes on chest radiograph. Which of the following is the most appropriate next step?

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Correct answer: A — Order high-resolution CT and pulmonary function testing and refer to respirology

Order high-resolution CT and pulmonary function testing and refer to respirology is the single best answer because the age, timing, examination findings and investigations in the vignette fit Interstitial lung disease better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to Canadian Thoracic Society ILD guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: Canadian Thoracic Society ILD guidance