Chest imaging: pneumomediastinum: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Radiology · Chest imaging: pneumomediastinum

Sample item

A young asthmatic with severe coughing has chest pain and neck crepitus. A radiograph shows linear lucencies outlining the mediastinum and the central part of the diaphragm is visible as a continuous line beneath the heart. What does this describe?

ALobar pneumonia with air bronchogramsBPneumopericardium with a heart shadow separate from the pericardiumCPneumomediastinum with the continuous diaphragm signDTension pneumothorax with a deep sulcus

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Pneumomediastinum with the continuous diaphragm sign

Air tracking from ruptured alveoli along the bronchovascular sheaths reaches the mediastinum, outlining structures and the central diaphragm, which is normally hidden by the heart. A ring around the artery and a thymic sail are other signs.

Option by option

A. Lobar pneumonia with air bronchograms
Air bronchograms indicate consolidation and do not produce neck crepitus.
B. Pneumopericardium with a heart shadow separate from the pericardium
Pneumopericardium is air confined by the pericardium and does not extend to the neck.
C. Pneumomediastinum with the continuous diaphragm sign (correct)
Correct. Mediastinal air lets the central diaphragm be seen as a continuous line.
D. Tension pneumothorax with a deep sulcus
A tension pneumothorax shows hemithorax lucency with shift, not mediastinal outlining.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is C, Pneumomediastinum with the continuous diaphragm sign. Air tracking from ruptured alveoli along the bronchovascular sheaths reaches the mediastinum, outlining structures and the central diaphragm, which is normally hidden by the heart.

Why is "Lobar pneumonia with air bronchograms" not the answer?

Air bronchograms indicate consolidation and do not produce neck crepitus.

Why is "Pneumopericardium with a heart shadow separate from the pericardium" not the answer?

Pneumopericardium is air confined by the pericardium and does not extend to the neck.

Why is "Tension pneumothorax with a deep sulcus" not the answer?

A tension pneumothorax shows hemithorax lucency with shift, not mediastinal outlining.

What concept does this question test?

It tests Chest imaging: pneumomediastinum in Radiology. A ring around the artery and a thymic sail are other signs.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Chest imaging: pneumomediastinum?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.