HIGH-YIELD Q&A GUIDE FOR CLIN MED
PULMONOLOGY EXAM 3 — RESTRICTIVE LUNG
DISEASE, ILD, PNEUMOCONIOSIS & SARCOIDOSIS
Q: What defines restrictive lung disease?
A: Restrictive lung disease is marked by reduced total lung expansion due to
factors such as fibrosis, scarring, chest wall deformities, neuromuscular weakness,
or elevated abdominal pressure.
Q: How do lung volumes and expiratory flow rates change in restrictive disorders?
A:
Lung volumes: decreased
Expiratory flow rates: generally normal because airway caliber is preserved.
Q: What happens to FEV₁ and FVC in restrictive lung disease?
A: Both FEV₁ and FVC decrease, but the FEV₁/FVC ratio usually remains normal
or increased.
Idiopathic Pulmonary Fibrosis (IPF)
Q: What is idiopathic pulmonary fibrosis?
,A: A chronic, progressive interstitial lung disease characterized by fibrosis and
inflammation of the lung parenchyma with no identifiable cause. Diagnosis is
made after excluding other sources of ILD.
Q: What imaging findings are characteristic of IPF?
A: Honeycombing and ground-glass opacities on HRCT or CXR.
Q: What is the most common interstitial lung disease of unknown etiology?
A: Idiopathic pulmonary fibrosis.
Q: What type of cough do IPF patients usually have?
A: An insidious, dry (nonproductive) cough.
Q: What imaging study is preferred for diagnosing IPF?
A: High-resolution CT (HRCT).
Q: True or False — Effective medical management exists for idiopathic pulmonary
fibrosis.
,A: False. There is no curative medical therapy. Management focuses on slowing
progression and supportive care.
Q: What medications may help slow progression in IPF?
A: Antifibrotic agents (e.g., nintedanib, pirfenidone).
Q: Is lung transplantation an option for IPF?
A: Yes—a lung transplant may be considered in advanced disease.
Pneumoconiosis
Q: What pneumoconiosis presents with progressive dyspnea, occupational
exposure from construction/demolition, and basilar reticular opacities with
honeycombing?
A: Asbestosis, a type of pneumoconiosis.
Q: What severe complication can occur in advanced pneumoconiosis?
A: Pulmonary hypertension.
Q: How long after asbestos exposure do symptoms typically develop?
, A: Usually 15–20 years after exposure.
Q: What are key CXR findings in pneumoconiosis?
A:
Pleural plaques
Honeycombing
“Shaggy heart” sign (obscured cardiac borders)
Q: What is the definitive diagnostic test for pneumoconiosis?
A: Lung biopsy. (Though rarely needed if classic exposure and imaging findings
are present.)
Q: What is the most common complication of pneumoconiosis?
A: Bronchogenic carcinoma.
Q: What is Caplan’s syndrome?
PULMONOLOGY EXAM 3 — RESTRICTIVE LUNG
DISEASE, ILD, PNEUMOCONIOSIS & SARCOIDOSIS
Q: What defines restrictive lung disease?
A: Restrictive lung disease is marked by reduced total lung expansion due to
factors such as fibrosis, scarring, chest wall deformities, neuromuscular weakness,
or elevated abdominal pressure.
Q: How do lung volumes and expiratory flow rates change in restrictive disorders?
A:
Lung volumes: decreased
Expiratory flow rates: generally normal because airway caliber is preserved.
Q: What happens to FEV₁ and FVC in restrictive lung disease?
A: Both FEV₁ and FVC decrease, but the FEV₁/FVC ratio usually remains normal
or increased.
Idiopathic Pulmonary Fibrosis (IPF)
Q: What is idiopathic pulmonary fibrosis?
,A: A chronic, progressive interstitial lung disease characterized by fibrosis and
inflammation of the lung parenchyma with no identifiable cause. Diagnosis is
made after excluding other sources of ILD.
Q: What imaging findings are characteristic of IPF?
A: Honeycombing and ground-glass opacities on HRCT or CXR.
Q: What is the most common interstitial lung disease of unknown etiology?
A: Idiopathic pulmonary fibrosis.
Q: What type of cough do IPF patients usually have?
A: An insidious, dry (nonproductive) cough.
Q: What imaging study is preferred for diagnosing IPF?
A: High-resolution CT (HRCT).
Q: True or False — Effective medical management exists for idiopathic pulmonary
fibrosis.
,A: False. There is no curative medical therapy. Management focuses on slowing
progression and supportive care.
Q: What medications may help slow progression in IPF?
A: Antifibrotic agents (e.g., nintedanib, pirfenidone).
Q: Is lung transplantation an option for IPF?
A: Yes—a lung transplant may be considered in advanced disease.
Pneumoconiosis
Q: What pneumoconiosis presents with progressive dyspnea, occupational
exposure from construction/demolition, and basilar reticular opacities with
honeycombing?
A: Asbestosis, a type of pneumoconiosis.
Q: What severe complication can occur in advanced pneumoconiosis?
A: Pulmonary hypertension.
Q: How long after asbestos exposure do symptoms typically develop?
, A: Usually 15–20 years after exposure.
Q: What are key CXR findings in pneumoconiosis?
A:
Pleural plaques
Honeycombing
“Shaggy heart” sign (obscured cardiac borders)
Q: What is the definitive diagnostic test for pneumoconiosis?
A: Lung biopsy. (Though rarely needed if classic exposure and imaging findings
are present.)
Q: What is the most common complication of pneumoconiosis?
A: Bronchogenic carcinoma.
Q: What is Caplan’s syndrome?
