Chest imaging: usual interstitial pneumonia: 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 imaging: usual interstitial pneumonia

Sample item

HRCT of an elderly patient with progressive dyspnoea and finger clubbing shows basal and subpleural reticulation, traction bronchiectasis and honeycombing. Which pattern and diagnosis fit?

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

The answer and the reasoning

D. Usual interstitial pneumonia pattern (idiopathic pulmonary fibrosis)

UIP is characterised by basal, subpleural predominant reticulation and honeycombing with traction bronchiectasis and minimal ground glass. When typical on HRCT, biopsy is unnecessary for the diagnosis of IPF. Antifibrotics such as pirfenidone and nintedanib slow decline.

Option by option

  • A. Sarcoidosis with perilymphatic nodules

    Sarcoid shows perilymphatic nodules along bronchovascular bundles.

  • B. Hypersensitivity pneumonitis with upper lobe centrilobular nodules

    Hypersensitivity pneumonitis shows ill-defined centrilobular nodules and air trapping.

  • C. Nonspecific interstitial pneumonia with ground glass only

    NSIP shows predominantly ground glass with subpleural sparing and little honeycombing.

  • D. Usual interstitial pneumonia pattern (idiopathic pulmonary fibrosis) (correct)

    Correct. Basal subpleural honeycombing is UIP, the pattern of IPF.

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 D, Usual interstitial pneumonia pattern (idiopathic pulmonary fibrosis). UIP is characterised by basal, subpleural predominant reticulation and honeycombing with traction bronchiectasis and minimal ground glass.

Why is "Sarcoidosis with perilymphatic nodules" not the answer?

Sarcoid shows perilymphatic nodules along bronchovascular bundles.

Why is "Hypersensitivity pneumonitis with upper lobe centrilobular nodules" not the answer?

Hypersensitivity pneumonitis shows ill-defined centrilobular nodules and air trapping.

Why is "Nonspecific interstitial pneumonia with ground glass only" not the answer?

NSIP shows predominantly ground glass with subpleural sparing and little honeycombing.

What concept does this question test?

It tests Chest imaging: usual interstitial pneumonia in Radiology. When typical on HRCT, biopsy is unnecessary for the diagnosis of IPF. Antifibrotics such as pirfenidone and nintedanib slow decline.

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 imaging: usual interstitial pneumonia?

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.