American Board of Internal Medicine (ABIM) Certification Practice Exam

Which condition can be diagnosed using a bronchoscopic biopsy?

1. Lung cancer

2. Pneumonia

3. Pulmonary sarcoidosis

4. Bronchitis

The correct answer is: Pulmonary sarcoidosis

A bronchoscopic biopsy is a valuable procedure for obtaining tissue samples from the lungs and bronchial tree. It is particularly useful in diagnosing conditions that involve a definitive histological examination to differentiate between various lung pathologies. In the case of pulmonary sarcoidosis, bronchoscopic biopsy is a primary diagnostic tool. Sarcoidosis is characterized by the formation of granulomas, which can be sampled via bronchoscopy for confirmation. The biopsy can help to identify non-caseating granulomas, which are characteristic of sarcoidosis, differentiating it from other conditions that have similar clinical presentations. Lung cancer is also a condition that can often be diagnosed through a bronchoscopic biopsy. However, the option selected does not exclude the possibility of diagnosing lung cancer via this method; it is common to diagnose both. Pneumonia typically involves an infectious process and can be diagnosed through clinical evaluation and imaging. While it sometimes requires a biopsy for atypical cases (like in the presence of an abscess or specific infections), it is usually not the first-line method for standard pneumonia diagnosis. Bronchitis, especially acute bronchitis, is primarily diagnosed clinically and does not require a biopsy for confirmation, as it often stems from infectious or inflammatory processes rather than any distinct pathological tissue