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Pulmonary arterial hypertension — USMLE Step 3 MCQ

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HardInternal Medicine (chronic management)Pulmonary arterial hypertensionUSMLE Step 3

A 49-year-old woman with systemic sclerosis has progressive exertional dyspnea. Examination shows loud P2 and mild leg edema. Pulmonary function tests show isolated low DLCO and echocardiography estimates elevated pulmonary artery pressure. Which of the following is the most likely diagnosis?

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Correct answer: B — Pulmonary arterial hypertension

Systemic sclerosis with progressive dyspnea, loud P2, edema, low DLCO, and elevated pulmonary pressures suggests pulmonary arterial hypertension.

Reference: ESC/ERS pulmonary hypertension guideline