NBME 14 SECTION 2 QUESTIONS AND
ANSWERS WITH VERIFIED SOLUTIONS 100%
What is the patient's chief complaint? - ANSWER
Progressive shortness of breath
What exacerbates the patient's shortness of breath?
- ANSWER Walking more than one city block and
walking up one flight of stairs
What does the patient feel during episodes of
shortness of breath? - ANSWER The need to
breathe rapidly
What other symptom does the patient have? -
ANSWER Dry cough
What symptoms does the patient not have? -
ANSWER Chest pain, diaphoresis, nocturnal
symptoms, worsening of symptoms when lying
down
,What is the patient's medical history? - ANSWER
Hypertension treated with enalapril and
hydrochlorothiazide
Has the patient ever smoked cigarettes? - ANSWER
No
What is the patient's temperature? - ANSWER
37°C (98.6°F)
What is the patient's pulse rate? - ANSWER
89/min
What is the patient's respiratory rate? - ANSWER
18/min
What is the patient's blood pressure? - ANSWER
145/82 mm Hg
, What is the patient's oxygen saturation on room
air? - ANSWER 90%
What is heard on auscultation of the lungs? -
ANSWER Crackles at both lung bases
What does the high-resolution CT scan of the chest
show? - ANSWER Reticulogranular appearance at
the bases bilaterally with minimal fibrosis
What is the result of the pulmonary function tests?
- ANSWER Moderately severe decreased diffusion
capacity
What is seen on examination of bronchoalveolar
lavage fluid? - ANSWER Many segmented
neutrophils that are negative for bacteria, fungi,
and acid-fast bacilli
What is the most appropriate next step in
management? - ANSWER Administration of
Prednisone
ANSWERS WITH VERIFIED SOLUTIONS 100%
What is the patient's chief complaint? - ANSWER
Progressive shortness of breath
What exacerbates the patient's shortness of breath?
- ANSWER Walking more than one city block and
walking up one flight of stairs
What does the patient feel during episodes of
shortness of breath? - ANSWER The need to
breathe rapidly
What other symptom does the patient have? -
ANSWER Dry cough
What symptoms does the patient not have? -
ANSWER Chest pain, diaphoresis, nocturnal
symptoms, worsening of symptoms when lying
down
,What is the patient's medical history? - ANSWER
Hypertension treated with enalapril and
hydrochlorothiazide
Has the patient ever smoked cigarettes? - ANSWER
No
What is the patient's temperature? - ANSWER
37°C (98.6°F)
What is the patient's pulse rate? - ANSWER
89/min
What is the patient's respiratory rate? - ANSWER
18/min
What is the patient's blood pressure? - ANSWER
145/82 mm Hg
, What is the patient's oxygen saturation on room
air? - ANSWER 90%
What is heard on auscultation of the lungs? -
ANSWER Crackles at both lung bases
What does the high-resolution CT scan of the chest
show? - ANSWER Reticulogranular appearance at
the bases bilaterally with minimal fibrosis
What is the result of the pulmonary function tests?
- ANSWER Moderately severe decreased diffusion
capacity
What is seen on examination of bronchoalveolar
lavage fluid? - ANSWER Many segmented
neutrophils that are negative for bacteria, fungi,
and acid-fast bacilli
What is the most appropriate next step in
management? - ANSWER Administration of
Prednisone
