Chest and cardiac imaging: pulmonary venous hypertension: 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 and cardiac imaging: pulmonary venous hypertension

Sample item

A patient with mitral stenosis has a chest radiograph with upper-zone vessels larger than lower-zone vessels and no alveolar shadows. What does this pattern indicate?

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

The answer and the reasoning

C. Pulmonary venous hypertension

Raised left atrial pressure causes redistribution of blood flow to the upper zones, called cephalisation or upper lobe diversion. A left-to-right shunt enlarges vessels evenly in all zones, and right outflow obstruction reduces vessel size. Embolism causes focal oligaemia rather than upper-zone enlargement.

Option by option

  • A. Pulmonary plethora from a left-to-right shunt

    Shunt plethora enlarges vessels uniformly in all zones.

  • B. Acute pulmonary embolism

    Embolism causes focal oligaemia such as the Westermark sign.

  • C. Pulmonary venous hypertension (correct)

    Correct. Upper-zone vascular prominence reflects raised pulmonary venous pressure.

  • D. Pulmonary oligaemia from right outflow obstruction

    Oligaemia shows small vessels and dark lung fields.

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 C, Pulmonary venous hypertension. Raised left atrial pressure causes redistribution of blood flow to the upper zones, called cephalisation or upper lobe diversion.

Why is "Pulmonary plethora from a left-to-right shunt" not the answer?

Shunt plethora enlarges vessels uniformly in all zones.

Why is "Acute pulmonary embolism" not the answer?

Embolism causes focal oligaemia such as the Westermark sign.

Why is "Pulmonary oligaemia from right outflow obstruction" not the answer?

Oligaemia shows small vessels and dark lung fields.

What concept does this question test?

It tests Chest and cardiac imaging: pulmonary venous hypertension in Radiology. A left-to-right shunt enlarges vessels evenly in all zones, and right outflow obstruction reduces vessel size. Embolism causes focal oligaemia rather than upper-zone enlargement.

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 Chest and cardiac imaging: pulmonary venous hypertension?

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.