Chest imaging: subpulmonic effusion: 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: subpulmonic effusion

Sample item

A patient's erect chest film shows an apparently elevated right hemidiaphragm with its highest point displaced laterally and a blunted costophrenic angle. What is the best next step to confirm the suspicion?

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

The answer and the reasoning

A. Lateral decubitus film or ultrasound to show free pleural fluid

Fluid beneath the lung mimics a high diaphragm, and the dome appears flattened with its peak shifted laterally. A decubitus view or ultrasound shows fluid layering. A sniff test checks for diaphragmatic paralysis, which does not fit this picture.

Option by option

  • A. Lateral decubitus film or ultrasound to show free pleural fluid (correct)

    Correct. Decubitus imaging or ultrasound demonstrates the fluid.

  • B. Immediate CT pulmonary angiography

    CTPA does not answer the question and exposes the patient to contrast and radiation.

  • C. Repeat the film at full expiration

    An expiratory film would not clarify the presence of fluid.

  • D. Fluoroscopic sniff test

    A sniff test evaluates paralysis, not fluid.

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 A, Lateral decubitus film or ultrasound to show free pleural fluid. Fluid beneath the lung mimics a high diaphragm, and the dome appears flattened with its peak shifted laterally.

Why is "Immediate CT pulmonary angiography" not the answer?

CTPA does not answer the question and exposes the patient to contrast and radiation.

Why is "Repeat the film at full expiration" not the answer?

An expiratory film would not clarify the presence of fluid.

Why is "Fluoroscopic sniff test" not the answer?

A sniff test evaluates paralysis, not fluid.

What concept does this question test?

It tests Chest imaging: subpulmonic effusion in Radiology. A decubitus view or ultrasound shows fluid layering. A sniff test checks for diaphragmatic paralysis, which does not fit this picture.

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: subpulmonic effusion?

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.