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Pulmonary fibrosis — USMLE Step 3 MCQ

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ModerateInternal Medicine (chronic management)Pulmonary fibrosisUSMLE Step 3

A 72-year-old man has progressive exertional dyspnea and dry cough. Exam shows bibasilar inspiratory crackles and finger clubbing. High-resolution CT shows subpleural basal reticulation and honeycombing. Which of the following is the most likely diagnosis?

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Correct answer: B — Idiopathic pulmonary fibrosis

Older age, progressive dyspnea, crackles, clubbing, and usual interstitial pneumonia pattern support idiopathic pulmonary fibrosis.

Reference: ATS/ERS idiopathic pulmonary fibrosis guideline