American Board of Internal Medicine (ABIM) Certification Practice Exam

Which therapy may be considered for treating interstitial lung disease associated with MCTD?

1. Methotrexate

2. Calcium Channel Blockers

3. Cyclophosphamide

4. Daily Aspirin

The correct answer is: Cyclophosphamide

Cyclophosphamide is considered a viable therapy for treating interstitial lung disease associated with mixed connective tissue disease (MCTD) due to its potent immunosuppressive effects. Interstitial lung disease in the context of MCTD is often related to significant inflammation and fibrosis in the lungs. Cyclophosphamide works by modulating the immune response and has been shown to be effective in managing various forms of lung involvement in connective tissue diseases. This medication can help reduce the inflammatory processes contributing to interstitial lung disease, leading to improved lung function and potentially preventing the progression of pulmonary fibrosis, a concern in MCTD patients. It is often indicated when patients experience moderate to severe pulmonary involvement or when other treatments have not yielded sufficient results. Other therapies mentioned, while they may be used in different contexts, do not specifically address the complex inflammatory mechanisms typical of interstitial lung disease associated with MCTD. Methotrexate is often used in other forms of inflammatory lung disease but may not be as effective as cyclophosphamide in cases involving significant lung fibrosis. Calcium channel blockers can be used for pulmonary hypertension but do not directly target the underlying interstitial lung disease. Daily aspirin is more relevant for its anti-inflammatory properties but is not a primary treatment