Chest imaging: allergic bronchopulmonary aspergillosis: 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: allergic bronchopulmonary aspergillosis

Sample item

An asthmatic patient with raised IgE and eosinophilia has recurrent opacities. HRCT shows central bronchiectasis with branching tubular opacities from mucus plugging, a finger-in-glove appearance. What is the diagnosis?

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

The answer and the reasoning

D. Allergic bronchopulmonary aspergillosis

Hypersensitivity to Aspergillus causes mucoid impaction of central, dilated bronchi, giving finger-in-glove opacities and central bronchiectasis with sparing of the periphery. Treatment involves corticosteroids and antifungal agents.

Option by option

  • A. Aspergilloma

    An aspergilloma is a fungal ball within a pre-existing cavity.

  • B. Invasive aspergillosis

    Invasive aspergillosis occurs in immunocompromised patients, with nodules and a halo sign.

  • C. Primary ciliary dyskinesia

    Ciliary dyskinesia causes basal bronchiectasis with sinusitis and situs inversus in some.

  • D. Allergic bronchopulmonary aspergillosis (correct)

    Correct. Central bronchiectasis with mucoid impaction is typical.

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, Allergic bronchopulmonary aspergillosis. Hypersensitivity to Aspergillus causes mucoid impaction of central, dilated bronchi, giving finger-in-glove opacities and central bronchiectasis with sparing of the periphery.

Why is "Aspergilloma" not the answer?

An aspergilloma is a fungal ball within a pre-existing cavity.

Why is "Invasive aspergillosis" not the answer?

Invasive aspergillosis occurs in immunocompromised patients, with nodules and a halo sign.

Why is "Primary ciliary dyskinesia" not the answer?

Ciliary dyskinesia causes basal bronchiectasis with sinusitis and situs inversus in some.

What concept does this question test?

It tests Chest imaging: allergic bronchopulmonary aspergillosis in Radiology. Treatment involves corticosteroids and antifungal agents.

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: allergic bronchopulmonary aspergillosis?

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.