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Chronic hypersensitivity pneumonitis — RCPSC IM MCQ

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HardRespirologyChronic hypersensitivity pneumonitisRCPSC IM

A bird breeder has progressive dyspnea, mosaic attenuation, centrilobular nodules, upper-lobe fibrosis and bronchoalveolar lavage lymphocytosis. What intervention is most important?

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Correct answer: C — Eliminate the avian antigen exposure and obtain interstitial-lung-disease follow-up

The best answer is “Eliminate the avian antigen exposure and obtain interstitial-lung-disease follow-up”. The pattern supports fibrotic hypersensitivity pneumonitis, for which antigen identification and avoidance are fundamental. Specialist assessment then determines whether anti-inflammatory or antifibrotic therapy is appropriate; continued exposure drives progression. Exposure assessment should be specific enough to identify hidden avian antigen sources in the home, workplace, clothing and ventilation systems.

Reference: Canadian Thoracic Society, 2023 COPD pharmacotherapy guideline: https://cts-sct.ca/guideline-library/