Pulmonary function test in dyspnea and arthritis case! - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 2 CK Forum

USMLE Step 2 CK Forum USMLE Step 2 CK Discussion Forum: Let's talk about anything related to USMLE Step 2 CK exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 07-18-2011
aksyonez's Avatar
USMLE Forums Veteran
 
Steps History: 1+CK+CS
Posts: 218
Threads: 74
Thanked 116 Times in 64 Posts
Reputation: 128
Lungs Pulmonary function test in dyspnea and arthritis case!

A 55-yr-man presents to your office with shortness of breath that has been worsening over the past 6 months. Initially he had dyspnea on exertion, but this evolved into dyspnea at rest, as well as a non productive cough for the past month. He denies weight loss, fever, night sweats.
On further review of systems he complains of pain and swelling in his hands. He also notes that his body feels stiff in the morning. He has no other significant past medical history and is taking no medication except for ibuprofen for his hand pain. He has never smoked. On physical he has crakles at the lung bases bilaterally. He has enlarged metacarpophalangeal joints bilaterally. They are red, warm, and tender to palpation. He also has slight ulnar deviation of the fingers. What will pulmonary function test reveal in this patient?

A. Decreased ration FEV1 : FVC
B. Increased residual volume
C. Increased total lung capacity
D. Normal or increased ration FEV1:FVC and decreased CO diffusion capacity
E. Normal or increased ration of FEV1:FVC and normal CO diffusion capacity
Reply With Quote Quick reply to this message
The above post was thanked by:
rulz (07-19-2011), usluipek (07-19-2011)



  #2  
Old 07-18-2011
USMLE Forums Scout
 
Steps History: 1 + CS
Posts: 11
Threads: 1
Thanked 4 Times in 4 Posts
Reputation: 14
Default

I think it's D
Reply With Quote Quick reply to this message
  #3  
Old 07-18-2011
USMLE Forums Veteran
 
Steps History: Not yet
Posts: 200
Threads: 101
Thanked 197 Times in 65 Posts
Reputation: 220
Default

D. Normal or increased ration FEV1:FVC and decreased CO diffusion capacity
Reply With Quote Quick reply to this message
 
  #4  
Old 07-18-2011
Ace3's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 735
Threads: 89
Thanked 289 Times in 191 Posts
Reputation: 301
Default

D..............
Reply With Quote Quick reply to this message
  #5  
Old 07-18-2011
akua's Avatar
USMLE Forums Addict
 
Steps History: Not yet
Posts: 167
Threads: 0
Thanked 31 Times in 31 Posts
Reputation: 41
Default

Answer A decreased FEV:FVC ratio
Reply With Quote Quick reply to this message
  #6  
Old 07-18-2011
USMLE Forums Master
 
Steps History: Step 1 Only
Posts: 567
Threads: 25
Thanked 524 Times in 263 Posts
Reputation: 534
Default

i'll go with a or D... still dont know... because This auto-immune process can mimic a Restrictive disease which is Decrease FEV/FVC ration but the other option or is a distractor or i dont know <> Decreased FEV/FVC ratio with decreased CO..


I will go with A...
Reply With Quote Quick reply to this message
  #7  
Old 07-18-2011
dr.muhamad's Avatar
USMLE Forums Guru
 
Steps History: 1 + CS
Posts: 300
Threads: 22
Thanked 97 Times in 62 Posts
Reputation: 107
Default

ddddddddddddddddddddddddddddddddddddddd
Reply With Quote Quick reply to this message
  #8  
Old 07-19-2011
aksyonez's Avatar
USMLE Forums Veteran
 
Steps History: 1+CK+CS
Posts: 218
Threads: 74
Thanked 116 Times in 64 Posts
Reputation: 128
Default

The correct answer is D. This patient is presenting with classic signs and symptoms of RA. The combination of RA with dyspnea and crackles is suggestive of RA-associated interstitial lung disease, the most common manifestation of rheumatoid lung disease. Patients with RA associated interstitial lung disease present with idiopathic pulmonary fibrosis, dyspnea, non productive cough, crackles, and clubbing in late disease. Lung disease is the most common in patients 50-60 years old and is more common in men. Interstitial lung disease causes a restricitve pattern:
TLC, FVC,FEV 1, residual volume are all decreased.
FEV1/FVC is normal or increased
The CO diffusion capacity is reduced due to inflammation and scarring of lung tissue.
Reply With Quote Quick reply to this message
The above post was thanked by:
rulz (07-19-2011), usluipek (07-19-2011)



Reply

Tags
Internal-Medicine-, Pulmonology-, Step-2-Questions

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
What the cause of dyspnea in this patient? DrNada USMLE Step 2 CK Forum 14 06-24-2015 12:19 PM
Arthritis and Eye Lesions USMLE-Syndrome USMLE Step 2 CK Classic Clues 1 07-17-2011 09:50 AM
dyspnea on exertion case USMLE-Syndrome USMLE Step 2 CK Forum 8 06-25-2011 01:05 PM
Pulmonary Function Test in an Asthmatic RRMadukha USMLE Step 2 CK Forum 5 06-19-2011 01:47 PM
How to treat this dyspnea case! USMLE-Syndrome USMLE Step 2 CK Forum 6 06-16-2011 09:20 AM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)