ABIM Pulmonology 5

Question 1

A 30-year-old woman has erythema nodosum, bilateral hilar lymphadenopathy, ankle arthritis, and fever. What is the most appropriate management?

Accepted Answer

NSAIDs for symptoms; spontaneous remission is likely

Answer

Löfgren syndrome is an acute form of sarcoidosis with an excellent prognosis and usually resolves with supportive NSAID therapy.

Question 2

Which therapy slows the decline in FVC in idiopathic pulmonary fibrosis?

Accepted Answer

Nintedanib

Answer

Antifibrotics (nintedanib or pirfenidone) slow FVC decline in IPF, while combined immunosuppression causes harm.

Question 3

Which ventilator strategy reduces mortality in ARDS?

Accepted Answer

Tidal volume of 6 mL/kg predicted body weight with plateau pressure ≤30 cm H2O

Answer

Low-tidal-volume ventilation based on predicted body weight lowered mortality in the ARDSNet trial.

Question 4

In a stable patient with COPD at rest, which finding is an indication for long-term oxygen therapy?

Accepted Answer

PaO2 ≤55 mm Hg

Answer

Long-term oxygen improves survival when resting PaO2 is ≤55 mm Hg or SpO2 is ≤88%, or when PaO2 is 56–59 mm Hg with cor pulmonale or erythrocytosis.

Question 5

A patient with asthma has central bronchiectasis, total IgE >1000 IU/mL, and positive Aspergillus-specific IgE. What is the initial treatment?

Accepted Answer

Oral glucocorticoids, often with itraconazole

Answer

Allergic bronchopulmonary aspergillosis is treated with systemic glucocorticoids, and an azole such as itraconazole is often added to reduce exacerbations.

ABIM - American Board of Internal Medicine Practice Test

ABIM - American Board of Internal Medicine Practice Test

ABIM Pulmonology 5