Respiratory: silicosis: practice question

A Pathology 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

Pathology · Respiratory: silicosis

Sample item

A 45-year-old man who has worked for 20 years cutting sandstone has progressive breathlessness. Chest radiograph shows small nodular opacities in the upper zones and thin eggshell calcification of the hilar lymph nodes. For which complication is he at particular risk?

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

The answer and the reasoning

D. Pulmonary tuberculosis

Silica particles are engulfed by alveolar macrophages and damage them, releasing fibrogenic mediators that form silicotic nodules with whorled collagen. Macrophage dysfunction impairs defence against mycobacteria, so silicosis markedly increases susceptibility to tuberculosis, which is especially relevant in India. Eggshell calcification of hilar nodes is characteristic.

Option by option

  • A. Hepatic angiosarcoma

    Hepatic angiosarcoma is associated with vinyl chloride, arsenic and thorotrast.

  • B. Malignant pleural mesothelioma

    Mesothelioma is the cancer of asbestos exposure, not of silica.

  • C. Extrinsic allergic alveolitis

    Extrinsic allergic alveolitis follows inhaled organic antigens such as mouldy hay and not mineral dust.

  • D. Pulmonary tuberculosis (correct)

    Correct. Silicosis impairs macrophage function and strongly predisposes to tuberculosis.

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.

More Pathology questions

Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is D, Pulmonary tuberculosis. Silica particles are engulfed by alveolar macrophages and damage them, releasing fibrogenic mediators that form silicotic nodules with whorled collagen.

Why is "Hepatic angiosarcoma" not the answer?

Hepatic angiosarcoma is associated with vinyl chloride, arsenic and thorotrast.

Why is "Malignant pleural mesothelioma" not the answer?

Mesothelioma is the cancer of asbestos exposure, not of silica.

Why is "Extrinsic allergic alveolitis" not the answer?

Extrinsic allergic alveolitis follows inhaled organic antigens such as mouldy hay and not mineral dust.

What concept does this question test?

It tests Respiratory: silicosis in Pathology. Macrophage dysfunction impairs defence against mycobacteria, so silicosis markedly increases susceptibility to tuberculosis, which is especially relevant in India. Eggshell calcification of hilar nodes is characteristic.

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 Respiratory: silicosis?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology 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.