Chest imaging: hypersensitivity pneumonitis on HRCT: 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: hypersensitivity pneumonitis on HRCT

Sample item

A bird fancier has recurrent cough and breathlessness. HRCT shows poorly defined centrilobular ground-glass nodules, and expiratory images show lobular air trapping adjacent to normal and ground-glass lung. What is this appearance called?

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

The answer and the reasoning

B. The three-density sign of subacute hypersensitivity pneumonitis

In subacute hypersensitivity pneumonitis, three densities coexist: normal lung, ground-glass lung and air-trapped lung. This reflects small airway inflammation along with alveolar disease. Removal of the antigen is the main step in management.

Option by option

  • A. Crazy paving of alveolar proteinosis

    Crazy paving has smooth septal thickening with geographic borders.

  • B. The three-density sign of subacute hypersensitivity pneumonitis (correct)

    Correct. Mixed densities with air trapping are typical of hypersensitivity pneumonitis.

  • C. Honeycombing of usual interstitial pneumonia

    Honeycombing denotes end-stage fibrosis.

  • D. The halo sign of aspergillosis

    The halo sign is ground glass around a nodule in invasive fungal infection.

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 B, The three-density sign of subacute hypersensitivity pneumonitis. In subacute hypersensitivity pneumonitis, three densities coexist: normal lung, ground-glass lung and air-trapped lung.

Why is "Crazy paving of alveolar proteinosis" not the answer?

Crazy paving has smooth septal thickening with geographic borders.

Why is "Honeycombing of usual interstitial pneumonia" not the answer?

Honeycombing denotes end-stage fibrosis.

Why is "The halo sign of aspergillosis" not the answer?

The halo sign is ground glass around a nodule in invasive fungal infection.

What concept does this question test?

It tests Chest imaging: hypersensitivity pneumonitis on HRCT in Radiology. This reflects small airway inflammation along with alveolar disease. Removal of the antigen is the main step in management.

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: hypersensitivity pneumonitis on HRCT?

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.