Respiratory medicine: cryptogenic organising pneumonia: practice question

A General Medicine 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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General Medicine · Respiratory medicine: cryptogenic organising pneumonia

Sample item

A 55-year-old woman has had six weeks of dry cough and low-grade fever. CT shows patchy peripheral consolidations that have shifted site between scans, and two courses of antibiotics gave no benefit. Biopsy shows plugs of granulation tissue in the bronchioles and alveolar ducts with preserved lung architecture. What is the most appropriate treatment?

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

The answer and the reasoning

A. Oral prednisolone for several months

Cryptogenic organising pneumonia presents as a slowly resolving pneumonia that does not respond to antibiotics, with migratory consolidation on imaging and intraluminal granulation tissue plugs on biopsy. It responds well to corticosteroids, though relapse on tapering is common.

Option by option

  • A. Oral prednisolone for several months (correct)

    Correct. Corticosteroids give a good response in organising pneumonia.

  • B. Referral for lung transplantation

    Transplantation is for end-stage fibrotic disease, and this condition usually resolves with steroids.

  • C. Nintedanib

    Nintedanib is an antifibrotic used in progressive fibrosing interstitial lung disease, and this condition is steroid responsive.

  • D. Prolonged four-drug antitubercular therapy

    Antitubercular treatment is not indicated without evidence of mycobacterial 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 General Medicine question

What is the answer to this General Medicine question?

The best answer is A, Oral prednisolone for several months. Cryptogenic organising pneumonia presents as a slowly resolving pneumonia that does not respond to antibiotics, with migratory consolidation on imaging and intraluminal granulation tissue plugs on biopsy.

Why is "Referral for lung transplantation" not the answer?

Transplantation is for end-stage fibrotic disease, and this condition usually resolves with steroids.

Why is "Nintedanib" not the answer?

Nintedanib is an antifibrotic used in progressive fibrosing interstitial lung disease, and this condition is steroid responsive.

Why is "Prolonged four-drug antitubercular therapy" not the answer?

Antitubercular treatment is not indicated without evidence of mycobacterial infection.

What concept does this question test?

It tests Respiratory medicine: cryptogenic organising pneumonia in General Medicine. It responds well to corticosteroids, though relapse on tapering is common.

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 Respiratory medicine: cryptogenic organising pneumonia?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine 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.