Chest imaging: lung abscess: 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: lung abscess

Sample item

A chest radiograph of an alcoholic patient following aspiration shows a thick-walled cavity with an air-fluid level in the posterior segment of the right upper lobe. Which statement is correct?

AThe air-fluid level suggests communication with the bronchial treeBThe air-fluid level excludes a lung abscessCIt is always a hydatid cystDIt is pathognomonic of a bronchogenic cyst

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

The answer and the reasoning

A. The air-fluid level suggests communication with the bronchial tree

A lung abscess is a thick-walled cavity with a ragged inner wall and an air-fluid level because it communicates with an airway. Aspiration commonly affects the posterior segments of the upper lobes and the superior segments of the lower lobes when supine. Cavitating carcinoma should be considered in older patients with a thick irregular wall.

Option by option

A. The air-fluid level suggests communication with the bronchial tree (correct)
Correct. The level shows bronchial communication and drainage.
B. The air-fluid level excludes a lung abscess
A fluid level supports abscess.
C. It is always a hydatid cyst
Hydatid cysts have a thin wall and typical signs.
D. It is pathognomonic of a bronchogenic cyst
A bronchogenic cyst is a thin-walled and often mediastinal lesion.

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.

Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is A, The air-fluid level suggests communication with the bronchial tree. A lung abscess is a thick-walled cavity with a ragged inner wall and an air-fluid level because it communicates with an airway.

Why is "The air-fluid level excludes a lung abscess" not the answer?

A fluid level supports abscess.

Why is "It is always a hydatid cyst" not the answer?

Hydatid cysts have a thin wall and typical signs.

Why is "It is pathognomonic of a bronchogenic cyst" not the answer?

A bronchogenic cyst is a thin-walled and often mediastinal lesion.

What concept does this question test?

It tests Chest imaging: lung abscess in Radiology. Aspiration commonly affects the posterior segments of the upper lobes and the superior segments of the lower lobes when supine. Cavitating carcinoma should be considered in older patients with a thick irregular wall.

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 imaging: lung abscess?

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.