Question of the Week

For January 21, 2020

A 74-year-old man is being followed for interstitial lung disease. Pulmonary function test results are consistent with restrictive lung disease, and he is found to have bibasilar honeycombing on CT of the chest. He reports slowly worsening dyspnea on exertion but says that he does not have fevers or worsening cough.

On physical examination, his vital signs are stable, with peripheral oxygen saturation of 95% on 4 liters of oxygen via nasal cannula. He does not desaturate with ambulation. Bilateral inspiratory crackles are noted at the lung bases.

Which one of the following therapeutic options is most likely to improve this patient’s quality of life?

Increased nocturnal supplemental oxygen
Lung transplantation
Pulmonary rehabilitation
Prednisone
Azathioprine

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