Chest and cardiac imaging: septic pulmonary emboli: 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: septic pulmonary emboli

Sample item

A man who injects drugs has fever and a tricuspid valve vegetation on echocardiography. CT chest shows multiple peripheral nodules, some cavitating, with vessels leading into them. What is the diagnosis?

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

The answer and the reasoning

A. Septic pulmonary emboli

Right-sided endocarditis seeds the lungs with infected emboli, producing peripheral, wedge-shaped, often cavitating nodules, with a feeding vessel sign. Blood cultures and echocardiography complete the work-up.

Option by option

  • A. Septic pulmonary emboli (correct)

    Correct. Peripheral cavitating nodules with feeding vessels and a right-heart vegetation fit septic emboli.

  • B. Bland pulmonary infarcts

    Bland infarcts are wedge-shaped without cavitation and arise without infection.

  • C. Miliary tuberculosis

    Miliary tuberculosis gives innumerable tiny uniform nodules without cavitation or feeding vessels.

  • D. Granulomatosis with polyangiitis

    Granulomatosis with polyangiitis can cavitate but presents with sinus, renal and ANCA features, not endocarditis.

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, Septic pulmonary emboli. Right-sided endocarditis seeds the lungs with infected emboli, producing peripheral, wedge-shaped, often cavitating nodules, with a feeding vessel sign.

Why is "Bland pulmonary infarcts" not the answer?

Bland infarcts are wedge-shaped without cavitation and arise without infection.

Why is "Miliary tuberculosis" not the answer?

Miliary tuberculosis gives innumerable tiny uniform nodules without cavitation or feeding vessels.

Why is "Granulomatosis with polyangiitis" not the answer?

Granulomatosis with polyangiitis can cavitate but presents with sinus, renal and ANCA features, not endocarditis.

What concept does this question test?

It tests Chest and cardiac imaging: septic pulmonary emboli in Radiology. Blood cultures and echocardiography complete the work-up.

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: septic pulmonary emboli?

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.