American Board of Internal Medicine (ABIM) Certification Practice Exam

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In the context of solitary pulmonary nodules, what is a characteristic of intermediate risk?

  1. Size greater than 2.0 cm

  2. Age under 40

  3. Current smoker

  4. Smooth margin characteristics

The correct answer is: Current smoker

In the context of solitary pulmonary nodules, being a current smoker is a characteristic that places an individual in the intermediate risk category for malignancy. Smoking history is a significant factor in assessing the probability that a pulmonary nodule may be cancerous. Current smokers have a higher risk of lung cancer, which elevates the risk associated with solitary pulmonary nodules. Regarding the other factors: size greater than 2.0 cm is typically associated with a higher risk, while age under 40 generally suggests a lower risk for malignancy, particularly in the absence of other risk factors. Smooth margin characteristics are typically associated with benign nodules, further suggesting a lower risk of malignancy. These contrasting characteristics highlight why a current smoking status is indicative of an intermediate risk for solitary pulmonary nodules.