Correct!
3. Pulmonary function testing
Thoracic MR and 18FDG-PET scanning would be of little use for evaluating this patient’s persistent shortness of breath in light of the lack of actionable findings in the mediastinum, lung parenchyma, and pleural space at thoracic CT. Bronchoscopy with biopsy and video-assisted thoracoscopic biopsy are also not appropriate as no clear target for tissue sampling is evident.
The patient underwent pulmonary function testing, which showed mixed results, including significant restriction, with a forced vital capacity of 1.67 L (58% predicted) and a forced expiratory volume in one second of 1.06 L (50% predicted). The forced expiratory flow rate was only 49% predicted. The flow-volume loop suggested some inspiratory flow restriction.
At this point, which of the following represents the most appropriate step in this patient’s management? (click on the correct answer to be directed to the tenth of 11 pages)