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Idiopathic pulmonary fibrosis — USMLE Step 3 MCQ

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HardInternal Medicine (chronic management)Idiopathic pulmonary fibrosisUSMLE Step 3

A 71-year-old man has progressive exertional dyspnea and dry cough for 1 year. He smoked previously. Examination shows bibasilar inspiratory crackles and digital clubbing. High-resolution CT shows subpleural basal reticulation and honeycombing without significant ground-glass opacity. 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 on CT support idiopathic pulmonary fibrosis.

Reference: ATS/ERS/JRS/ALAT Idiopathic Pulmonary Fibrosis Guideline