Respiratory medicine: aspergilloma: 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: aspergilloma

Sample item

A 45-year-old man with old cavitary tuberculosis has recurrent haemoptysis. The radiograph shows a mobile round mass within an upper-lobe cavity, separated from the wall by a crescent of air, and serum Aspergillus precipitins are positive. What is the most likely diagnosis?

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

The answer and the reasoning

A. Aspergilloma

A fungal ball of Aspergillus colonises a pre-existing cavity such as old tuberculosis or sarcoid. It moves with posture, causes an air-crescent sign and gives recurrent haemoptysis. Massive bleeding may need bronchial artery embolisation or resection.

Option by option

  • A. Aspergilloma (correct)

    Correct. A mobile intracavitary mass with an air crescent and positive precipitins is an aspergilloma.

  • B. Lung abscess

    A lung abscess has an air-fluid level and a thick wall, without a mobile ball.

  • C. Cavitating squamous carcinoma

    A cavitating carcinoma has a thick irregular wall and does not move with posture.

  • D. Reactivation of tuberculosis

    Reactivation of tuberculosis would not produce a mobile intracavitary mass.

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 General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is A, Aspergilloma. A fungal ball of Aspergillus colonises a pre-existing cavity such as old tuberculosis or sarcoid.

Why is "Lung abscess" not the answer?

A lung abscess has an air-fluid level and a thick wall, without a mobile ball.

Why is "Cavitating squamous carcinoma" not the answer?

A cavitating carcinoma has a thick irregular wall and does not move with posture.

Why is "Reactivation of tuberculosis" not the answer?

Reactivation of tuberculosis would not produce a mobile intracavitary mass.

What concept does this question test?

It tests Respiratory medicine: aspergilloma in General Medicine. It moves with posture, causes an air-crescent sign and gives recurrent haemoptysis. Massive bleeding may need bronchial artery embolisation or resection.

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: aspergilloma?

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.