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Interstitial lung disease — RCPSC IM MCQ

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HardRespirologyInterstitial lung diseaseRCPSC IM

A 66-year-old man has 18 months of progressive exertional dyspnea and dry cough. HRCT shows basal subpleural reticulation, traction bronchiectasis and honeycombing without ground-glass predominance. Autoimmune serology is negative, oxygen saturation falls to 84 percent on a 6-minute walk, and FVC is 68 percent predicted. What is the most appropriate management?

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Correct answer: A — Refer for antifibrotic therapy assessment, pulmonary rehabilitation and oxygen evaluation

A usual interstitial pneumonia pattern with progressive symptoms is consistent with idiopathic pulmonary fibrosis after excluding secondary causes. Management includes antifibrotic assessment, rehabilitation, oxygen assessment and transplant consideration when appropriate.

Reference: Canadian Thoracic Society interstitial lung disease practice; ATS/ERS/JRS/ALAT IPF guideline