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Idiopathic pulmonary fibrosis — ABIM Board MCQ

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HardPulmonary/Critical CareIdiopathic pulmonary fibrosisABIM Board

A 69-year-old former smoker has progressive exertional dyspnea and bibasilar inspiratory crackles. Spirometry shows restriction and reduced DLCO. Chest radiograph shows lower-lobe reticular opacities. Autoimmune serologies are negative. Which of the following is the most appropriate diagnostic study?

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Correct answer: B — High-resolution CT of the chest

Suspected idiopathic pulmonary fibrosis is evaluated with high-resolution CT to identify usual interstitial pneumonia features. Surgical lung biopsy is reserved for cases in which imaging and multidisciplinary evaluation remain indeterminate.

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