A 49-year-old white woman presents with progressive cough and dyspnea. She denies any history of arthritis, skin lesions, or eye complaints. On physical examination, vital signs are: pulse 90 bpm; temperature 98°F; respirations 32/min; blood pressure 119/76 mm Hg. General exam: patient is in moderate distress, and pertinent physical findings reveal clubbing of the fingers and bilateral "Velcro" rales on lung auscultation. ABGs on room air: pH 7.47; Pco2 32 mm Hg; Po2 60 mm Hg with further desaturation on mild exertion. Chest radiograph is shown below in Fig. 25.
44. Least likely to be associated with this condition is a. Positive antinuclear antigen b. Positive rheumatoid factor c. Increased erythrocyte sedimentation rate d. Increased IgE
45. What is the most likely diagnosis?
a. Idiopathic pulmonary fibrosis b. Langerhans granulomatosis/histiocytosis-X disorders c. Rheumatoid lung d. Sarcoidosis
46. PFTS would be expected to show a. An obstructive pattern b. A restrictive pattern c. A normal pattern d. A reversible obstructive pattern
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