American Board of Surgery Qualifying Exam (ABS QE) Practice Test

What is the term used to describe chronic lung transplant rejection characterized by the look of air trapping on expiration?

1. Interstitial fibrosis

2. Vanishing bile duct syndrome

3. Bronchiolitis obliterans

4. Accelerated arteriosclerosis

The correct answer is: Bronchiolitis obliterans

Chronic lung transplant rejection is a significant complication that can occur in patients who have undergone a lung transplant. The condition known as bronchiolitis obliterans is specifically associated with this type of rejection. It is characterized by the progressive narrowing and obstruction of the small airways (bronchioles) due to inflammation and fibrosis. Clinically, bronchiolitis obliterans leads to airflow obstruction, manifesting as air trapping on expiration during imaging studies, such as a CT scan or during spirometry. This is an important distinction as it directly relates to the diagnosis of chronic lung transplant rejection, unlike other conditions listed, which do not specifically pertain to lung transplants. For example, interstitial fibrosis refers to lung scarring that can occur due to various lung diseases but does not specifically describe the mechanism or features of chronic rejection in lung transplants. Vanishing bile duct syndrome relates to liver transplant complications, and accelerated arteriosclerosis generally pertains to vascular grafts rather than lung rejection. Understanding these distinctions is crucial for recognizing and managing post-transplant complications effectively.