A 75-year-old retired carpenter man has a 12-month history of cough and dyspnea. He has a 40-pack year history of smoking. On examination, BP 135/75mmHg. HR 88/min, RR 24/min, and oxygen saturation is 88% on room air. No jugular venous distension. Chest examination shows bibasilar inspiratory crepitation bilaterally. Pulmonary function test show decreased FEV1 and FVC, normal FEV1/FVC ratio, and decreased diffusing capacity of carbon monoxide. CT chest reveals traction bronchiectasis with septal thickening. Which of the following is the most likely diagnosis of this patient's presentation?
سؤال مجاني 5 من 10 اليوم · اشترك وكمّل بدون حد
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الإجابة والشرح
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الإجابة: C. Idiopathic pulmonary fibrosis
Bibasilar inspiratory crackles with a restrictive pattern (low FEV1 and FVC, normal ratio), low DLCO and fibrotic CT changes (traction bronchiectasis, septal thickening) fit idiopathic pulmonary fibrosis. COPD would give a low FEV1/FVC ratio, and heart failure is unlikely without JVD.
ليش كل خيار صح أو غلط
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A
ليش غلط
COPD is obstructive: low FEV1/FVC ratio with FEV1 lowered more than FVC; this patient has a normal ratio.
✓ Pulmonology 🫁.pdf · p. 3 -
B
ليش غلط
Left ventricular failure (pulmonary edema) is listed with medium crackles, while fine end-inspiratory crackles point to ILD or idiopathic lung fibrosis; he also has no JVD.
✓ Pulmonology 🫁.pdf · p. 38 -
C
ليش صح
Fine end-inspiratory crackles are typical of interstitial lung disease or idiopathic lung fibrosis, matching his bibasilar inspiratory crackles.
✓ Pulmonology 🫁.pdf · p. 38
- المصدر
- Pulmonology 🫁.pdf · p. 38
Pulmonology 🫁.pdf · p. 3 - المحاضرة
- Other Lung Diseases (ILD, Bronchiectasis, Lung Cancer) · Pulmonology · Module B
- ظهر في
- Respi bank