Chest and cardiac imaging: random nodule distribution: 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: random nodule distribution

Sample item

A febrile patient has 1 to 3 mm nodules on HRCT, scattered evenly through both lungs and involving subpleural, perifissural and central regions without relation to the secondary lobule. Which distribution is this?

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

The answer and the reasoning

C. Random (haematogenous)

Haematogenous spread, as in miliary tuberculosis or metastases, seeds nodules uniformly with no preference for lymphatic or bronchiolar structures. Distribution analysis on HRCT narrows the differential before any biopsy.

Option by option

  • A. Perilymphatic

    Perilymphatic nodules cluster along the pleura, fissures and bronchovascular bundles, as in sarcoidosis.

  • B. Centrilobular

    Centrilobular nodules spare the pleural surface and stay a few millimetres from it, as in airway disease.

  • C. Random (haematogenous) (correct)

    Correct. An even spread unrelated to lobular anatomy is the random pattern.

  • D. Segmental lobar

    Segmental lobar distribution describes airspace consolidation of a lung segment, not scattered nodules.

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, Random (haematogenous). Haematogenous spread, as in miliary tuberculosis or metastases, seeds nodules uniformly with no preference for lymphatic or bronchiolar structures.

Why is "Perilymphatic" not the answer?

Perilymphatic nodules cluster along the pleura, fissures and bronchovascular bundles, as in sarcoidosis.

Why is "Centrilobular" not the answer?

Centrilobular nodules spare the pleural surface and stay a few millimetres from it, as in airway disease.

Why is "Segmental lobar" not the answer?

Segmental lobar distribution describes airspace consolidation of a lung segment, not scattered nodules.

What concept does this question test?

It tests Chest and cardiac imaging: random nodule distribution in Radiology. Distribution analysis on HRCT narrows the differential before any biopsy.

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: random nodule distribution?

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.