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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 66-year-old man has progressive dyspnea and dry cough. He has bibasilar crackles and clubbing. High-resolution CT shows subpleural reticulation and honeycombing. Pulmonary function testing shows restriction and reduced diffusion capacity. Autoimmune serologies are negative. Which of the following is the most likely diagnosis?

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Correct answer: B — Idiopathic pulmonary fibrosis

Older age, progressive exertional dyspnea, bibasilar crackles, clubbing, restrictive physiology, and usual interstitial pneumonia pattern with honeycombing suggest idiopathic pulmonary fibrosis.

Reference: ATS/ERS/JRS/ALAT idiopathic pulmonary fibrosis guidance