Chest and cardiac imaging: NSIP pattern: 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: NSIP pattern

Sample item

A woman with systemic sclerosis has HRCT showing bilateral basal ground-glass opacities with fine reticulation, sparing of the immediate subpleural lung and minimal honeycombing. Which pattern is this?

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

The answer and the reasoning

A. Nonspecific interstitial pneumonia

NSIP is the commonest interstitial pattern in connective tissue disease. Ground glass dominates, honeycombing is minimal and a thin subpleural zone is spared, which separates it from UIP.

Option by option

  • A. Nonspecific interstitial pneumonia (correct)

    Correct. Basal ground glass with subpleural sparing and little honeycombing favours NSIP.

  • B. Pulmonary alveolar proteinosis

    Alveolar proteinosis gives crazy paving with sharply demarcated geographic areas.

  • C. Usual interstitial pneumonia

    UIP shows subpleural, basal honeycombing and traction bronchiectasis without subpleural sparing.

  • D. Pulmonary Langerhans cell histiocytosis

    Langerhans cell histiocytosis gives upper-zone nodules and bizarre cysts in smokers.

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 A, Nonspecific interstitial pneumonia. NSIP is the commonest interstitial pattern in connective tissue disease.

Why is "Pulmonary alveolar proteinosis" not the answer?

Alveolar proteinosis gives crazy paving with sharply demarcated geographic areas.

Why is "Usual interstitial pneumonia" not the answer?

UIP shows subpleural, basal honeycombing and traction bronchiectasis without subpleural sparing.

Why is "Pulmonary Langerhans cell histiocytosis" not the answer?

Langerhans cell histiocytosis gives upper-zone nodules and bizarre cysts in smokers.

What concept does this question test?

It tests Chest and cardiac imaging: NSIP pattern in Radiology. Ground glass dominates, honeycombing is minimal and a thin subpleural zone is spared, which separates it from UIP.

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 Chest and cardiac imaging: NSIP pattern?

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.