ABIM IM Practice Test 8
10 free ABIM IM practice questions in the real exam format, covering the official content areas, with an explanation for every answer.
Question 1 of 10
Pulmonary DiseaseA 71-year-old man is seen for 18 months of progressive exertional dyspnea and a dry cough. He is a former smoker (30 pack-years, quit 15 years ago) and a retired accountant. He has no birds, hot tub, home mold or occupational dust exposure. He has no joint pain, rash, Raynaud phenomenon, dysphagia or muscle weakness. He takes amlodipine for hypertension. Oxygen saturation is 93% breathing ambient air at rest and 86% after 2 minutes of walking. Fine bibasilar end-inspiratory crackles and digital clubbing are present; there is no skin thickening or synovitis. High-resolution CT shows subpleural, basal-predominant reticulation with honeycombing and traction bronchiectasis, without predominant ground-glass opacity, mosaic attenuation or nodules. FVC is 64% of predicted and DLCO is 48% of predicted. Laboratory results are shown. Which of the following is the most appropriate treatment?
| Test | Result | Reference range |
|---|---|---|
| Serum | ||
| Antinuclear antibodies | 1:40 | ≤1:40 |
| Rheumatoid factor | 12 IU/mL | <24 IU/mL |
| Anti-cyclic citrullinated peptide antibodies | 6 units | <20 units |
| Anti-Scl-70 antibodies | 0.3 U | Negative: <1.0 U |
| Creatine kinase | 110 U/L | Male: 55–170 U/L |