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USMLE · Question #476

USMLE Question #476: Real Exam Question with Answer & Explanation

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Question

A 45-year-old woman with systemic sclerosis (scleroderma) comes to the physician because of a 3-week history of progressive shortness of breath and nonproductive cough. Her temperature is 36.9°C (98.4°F), pulse is 82/min, respirations are 20/min, and blood pressure is 136/85 mmHg. Crackles are heard in both lower lung fields. Pulmonary function tests show total lung capacity is 80% of predicted, and diffusing capacity for carbon monoxide, corrected for alveolar volume, is 65% of predicted. Histologic examination of a lung biopsy specimen is most likely to show which of the following findings?

Options

  • ADiffuse interstitial fibrosis
  • BIntra-alveolar exudates
  • CMultiple thromboemboli
  • DNecrotizing vasculitis
  • ENon-necrotizing interstitial granulomas

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