QuestionSBA
QuestionChoice
This is incorrect. In bronchiectasis, an obstructive pattern would be seen on spirometry.
10027688
c
Bronchiectasis
QuestionChoice
This is correct. The patient takes methotrexate which is a known risk factor for pulmonary fibrosis. Her spirometry also shows a restrictive pattern with both FEV1 and FVC below the predicted normal level and a ratio >0.7. The pattern is specific to pulmonary fibrosis as the DLCO is also reduced.
10027686
a
Pulmonary fibrosis
QuestionChoice
This is incorrect. In asthma, an obstructive pattern would be seen on spirometry.
10027689
d
Asthma
QuestionChoice
This is incorrect. Although a restrictive pattern would also be seen in obesity hypoventilation syndrome, DLCO would not be expected to be affected.
10027690
e
Obesity hypoventilation syndrome
QuestionChoice
This is incorrect. In COPD, an obstructive pattern would be seen on spirometry.
10027687
b
Chronic obstructive pulmonary disease (COPD)
Concept
Chapter
2693
3693
Pulmonary Fibrosis
Topic
132
Respiratory
17935
A 65 year old female is seen in the respiratory clinic to receive her most recent spirometry results. She has been experiencing a dry cough and shortness of breath which has been progressively worsening over the last 4 months.

patient has a past me dical history of rheumatoid arthritis and takes methotrexate. They have never smoked and have no allergies.

The spirometry results are as follows:

FEV1: 68%
FVC: 60%
FEV1/FVC ratio: 0.84

Diffusion Capacity of the Lungs for carbon monoxide (DLCO): reduced.

Which of the following is the most likely underlying diagnosis?
a