Chest imaging: fibrocavitary tuberculosis: 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.

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Radiology · Chest imaging: fibrocavitary tuberculosis

Sample item

A chest radiograph of a man with chronic cough shows bilateral upper zone fibrosis, cavities and elevation of both hila with a straightened mediastinal contour. What is the likely cause of the hilar changes?

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

The answer and the reasoning

D. Upward retraction due to fibrosis and volume loss of the upper lobes

Post-primary tuberculosis scars and shrinks the upper lobes, pulling the hila upward and straightening the mediastinum, a feature that is useful to diagnose old fibrocavitary disease.

Option by option

  • A. Downward displacement from hyperinflation

    Hyperinflation displaces the hila down and does not suit the upper lobe scarring.

  • B. Enlargement from lymphoma

    Lymphoma enlarges nodes and does not retract the hila.

  • C. Pulmonary artery hypertension

    Pulmonary hypertension enlarges the central arteries rather than lifting them.

  • D. Upward retraction due to fibrosis and volume loss of the upper lobes (correct)

    Correct. Upper lobe fibrosis retracts the hila upward.

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.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is D, Upward retraction due to fibrosis and volume loss of the upper lobes. Post-primary tuberculosis scars and shrinks the upper lobes, pulling the hila upward and straightening the mediastinum, a feature that is useful to diagnose old fibrocavitary disease.

Why is "Downward displacement from hyperinflation" not the answer?

Hyperinflation displaces the hila down and does not suit the upper lobe scarring.

Why is "Enlargement from lymphoma" not the answer?

Lymphoma enlarges nodes and does not retract the hila.

Why is "Pulmonary artery hypertension" not the answer?

Pulmonary hypertension enlarges the central arteries rather than lifting them.

What concept does this question test?

It tests Chest imaging: fibrocavitary tuberculosis in Radiology. The correct option holds because: Correct. Upper lobe fibrosis retracts the hila upward.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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: fibrocavitary tuberculosis?

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.