Chest imaging: pulmonary arterial hypertension: 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: pulmonary arterial hypertension

Sample item

A chest radiograph shows enlarged central pulmonary arteries with an abrupt tapering of the peripheral vessels, and the right descending pulmonary artery measures 20 mm. What does this indicate?

APulmonary venous hypertension from acute pulmonary oedemaBLeft to right shunt with normal pressuresCPulmonary arterial hypertension with peripheral pruningDPulmonary oligaemia from a normal variant

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

The answer and the reasoning

C. Pulmonary arterial hypertension with peripheral pruning

Raised pulmonary vascular resistance dilates the central arteries and loses the peripheral vessels, giving pruning. A right descending pulmonary artery above about 16 mm is considered enlarged.

Option by option

A. Pulmonary venous hypertension from acute pulmonary oedema
Venous hypertension shows upper lobe diversion and septal lines.
B. Left to right shunt with normal pressures
A shunt without raised resistance shows increased flow in all vessels, not pruning.
C. Pulmonary arterial hypertension with peripheral pruning (correct)
Correct. Big central vessels and pruned peripheries are the radiographic signature.
D. Pulmonary oligaemia from a normal variant
A normal variant would not enlarge the central arteries.

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, Pulmonary arterial hypertension with peripheral pruning. Raised pulmonary vascular resistance dilates the central arteries and loses the peripheral vessels, giving pruning.

Why is "Pulmonary venous hypertension from acute pulmonary oedema" not the answer?

Venous hypertension shows upper lobe diversion and septal lines.

Why is "Left to right shunt with normal pressures" not the answer?

A shunt without raised resistance shows increased flow in all vessels, not pruning.

Why is "Pulmonary oligaemia from a normal variant" not the answer?

A normal variant would not enlarge the central arteries.

What concept does this question test?

It tests Chest imaging: pulmonary arterial hypertension in Radiology. A right descending pulmonary artery above about 16 mm is considered enlarged.

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: pulmonary arterial hypertension?

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.