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ENT · Airway: inhaled foreign body imaging
Sample itemA 2-year-old has sudden cough and wheeze after eating nuts, with reduced air entry on the right. An inspiratory chest film is normal. What additional imaging finding is expected in a ball-valve obstruction of the right bronchus?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
C. Hyperinflation of the right lung with air trapping on an expiratory film
A ball-valve foreign body allows air in on inspiration but traps it on expiration, so the affected lung stays hyperinflated and the mediastinum shifts to the opposite side on expiratory films. The foreign body is removed by rigid bronchoscopy under general anaesthesia.
Option by option
A. Bilateral pleural effusions
Effusion is not a feature.
B. Collapse of the right lung on inspiration only
Complete obstruction causes collapse, and this is a partial ball-valve effect.
C. Hyperinflation of the right lung with air trapping on an expiratory film (correct)
Correct. Air trapping is the typical radiographic sign of partial obstruction.
D. Cardiomegaly
The heart size is not affected.
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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