Respiratory medicine: pulmonary infarct on radiograph: 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: pulmonary infarct on radiograph

Sample item

A woman has sudden pleuritic chest pain and haemoptysis five days after a hip replacement. The chest radiograph shows a peripheral, pleura-based, wedge-shaped opacity with its apex towards the hilum. What does this opacity represent?

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

The answer and the reasoning

B. Pulmonary infarction from an embolus

A pleural-based wedge of consolidation due to pulmonary infarction is called a Hampton hump. Other radiographic signs of embolism, such as a focal oligaemia (Westermark sign), are uncommon, and the radiograph is often normal. CT pulmonary angiography is the confirmatory test.

Option by option

  • A. A cavitating lung abscess after aspiration

    An aspiration abscess usually shows a cavity with an air-fluid level and has a different setting.

  • B. Pulmonary infarction from an embolus (correct)

    Correct. A wedge-shaped, pleura-based opacity after surgery with haemoptysis indicates infarcted lung distal to an embolus.

  • C. A loculated pleural effusion in the fissure

    A loculated fissural effusion appears as a lens-shaped shadow rather than a wedge based on the pleura.

  • D. Lobar consolidation from pneumococcal pneumonia

    Pneumococcal consolidation is lobar and does not follow the wedge shape of a vascular territory.

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 B, Pulmonary infarction from an embolus. A pleural-based wedge of consolidation due to pulmonary infarction is called a Hampton hump.

Why is "A cavitating lung abscess after aspiration" not the answer?

An aspiration abscess usually shows a cavity with an air-fluid level and has a different setting.

Why is "A loculated pleural effusion in the fissure" not the answer?

A loculated fissural effusion appears as a lens-shaped shadow rather than a wedge based on the pleura.

Why is "Lobar consolidation from pneumococcal pneumonia" not the answer?

Pneumococcal consolidation is lobar and does not follow the wedge shape of a vascular territory.

What concept does this question test?

It tests Respiratory medicine: pulmonary infarct on radiograph in General Medicine. Other radiographic signs of embolism, such as a focal oligaemia (Westermark sign), are uncommon, and the radiograph is often normal. CT pulmonary angiography is the confirmatory test.

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 medicine: pulmonary infarct on radiograph?

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.